Use of endogenous viral vaccine in chimeric antigen receptor T cell therapy

ABSTRACT

Provided herein are, inter alia, methods and compositions including T cells expressing (i) a recombinant CAR protein which includes a peptide binding site and is capable of specifically binding cancer-specific antigens and (ii) a T cell receptor specific for a viral antigen (e.g., a CMV pp65 protein). The engineered T cells provided herein may be used in combination with a viral vaccine (e.g. cytomegalovirus (CMV) Triplex Vaccine) to treat a variety of cancers. The methods described herein also permit in vivo expansion of CMV-specific CAR T cells, instead of or in addition to ex vivo expansion, avoiding excessive T cell exhaustion that results in some cases from ex vivo manufacturing.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a division of U.S. patent application Ser. No.16/342,426, filed Apr. 16, 2019, which is a national stage filing underU.S.C. 371 of International Application No. PCT/US17/57466, filed Oct.19, 2017, which claims priority to U.S. Provisional Application No.62/410,383, filed Oct. 19, 2016, the disclosure of which areincorporated herein in their entireties and for all purposes.

REFERENCE TO A “SEQUENCE LISTING,” A TABLE, OR A COMPUTER PROGRAMLISTING APPENDIX SUBMITTED ON A COMPACT DISK

The Sequence Listing written in file 048440-632D01US_SL_ST25.TXT,created on Nov. 17, 2021, having 220,108 bytes, machine format IBM-PC,MS-Windows operating system, is hereby incorporated by reference in itsentirety for all purposes.

BACKGROUND OF THE INVENTION

Cancer is the second leading cause of death in the United States,killing more people than the next five causes combined including chronicrespiratory disease, Alzheimer's disease and diabetes. Whileextraordinary strides have been made in the detection, prevention andtreatment of cancer, there remains an urgent need, especially inadvanced cases, to produce therapies that not only halt tumorprogression but effectively eliminate all tumor cells. One approach isadoptive T cell immunotherapy (5-7). This method requires the harvestingof the patient's T cells, engineering of these cells with a chimericantigen receptor (CAR) that recognizes a tumor antigen, and subsequentre-introduction of the modified cells to the patient. The re-programmedT cells then directly target antigen-expressing tumor cells, bypassingthe requirement for MHC peptide, and elicit a powerful but localizedimmune response. This method of treatment (8) has produced some positiveresults in early clinical trials for a handful, but not for allpatients. There is a need in the art to better understand CAR T celltherapy's success and failure. For example, there is a need in the artfor the ability to characterize the density of the CARs on thetransformed cells, to track administered CAR T cells at any point duringtherapy and correlate this distribution to therapeutic outcomes, torapidly functionalize CAR T cells, monitoring the number, location andviability of the transplanted CAR T cells in situ and to selectivelyeliminate CAR T cells if necessary. Meaningful correlations would aidclinicians in determining the best treatment options and giveresearchers important clues to modify and improve this therapeuticapproach. Over 70,000 new cases of non-Hodgkin lymphoma (NHL) arediagnosed each year in the United States with about 20,000 deaths due toNHL each year, representing the 5th leading cause of cancer deaths. Themajority of these patients have widespread disease at the time ofdiagnosis and over two-thirds will suffer a recurrence after remissioninduction with cytotoxic chemotherapy and rituximab. Efforts to improvethe survival of patients with recurrent lymphoma have focused mainly onthe use of autologous hematopoietic cell transplant (HCT), which iscurative in approximately half of good-risk patients, but confers a lessthan 15% 5-year event-free survival in patients with poor prognosticfeatures. Allogeneic HCT provides a tumor-free stem cell graft, cellsthat have not been damaged by prior chemotherapy and the opportunity forgraft-versus-lymphoma (GVL) effect, and has been increasingly applied inpatients with relapsed NHL. Although relapse rates are improved overautologous HCT, allogeneic HCT is associated with both significant risksof transplant-related complications and also disease recurrence. Thus,there is an important need for the development of new therapies that canconsolidate the tumor cytoreduction achieved with autologous orallogeneic HCT by eradicating the limited number of tumor cellssurviving after autologous myeloablative and reduced intensityallogeneic conditioning. A Phase I clinical trial using ex vivo-expandedautologous central memory-enriched T cells (TCM) transduced withlentivirus expressing CD19-specific CAR has demonstrated the data safetyand feasibility of CD19 CAR T cell therapy after HCT Wang et al., Blood127:2980, 2016). Provided herein are compositions and methods addressingthese and other needs in the art

BRIEF SUMMARY OF THE INVENTION

In an aspect is provided a method for treating a disease in a subject inneed thereof, the method including: (i) administering to a subject atherapeutically effective amount of a composition including a populationof human T cells expressing a T cell receptor specific for acytomegalovirus (CMV) antigen and a recombinant chimeric antigenreceptor (CAR) protein, wherein the recombinant CAR protein includes:(A) an antibody region including a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein the central cavity forms a peptide binding site includingframework region amino acid residues; and (B) a transmembrane domain;and (ii) administering to the subject a therapeutically effective amountof a viral vector, wherein the viral vector encodes (a) a CMV pp65protein and (b) a fusion protein including exon 4 of CMV protein IE1(e4) and exon 5 of CMV protein IE2 (e5); and wherein the viral vector isadministered either prior to or subsequent to administering thecomposition including a population of human T cells to the subject,thereby treating the subject.

In an aspect is provided a method for forming a population of human Tcells expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen, the method including: (1) administering aviral vector encoding: (a) a CMV pp65 protein and (b) a fusion proteinincluding exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a CMV-seronegative human donor; (2) obtaining PBMCs from thehuman donor; (3) contacting the PBMCs with at least one CMV antigen; (3)allowing the contacted cells to produce a population of cells enrichedfor stimulated cells specific for CMV; (4) transducing at least aportion of the enriched population of cells with a vector expressing arecombinant CAR protein, thereby forming a population of human T cellsexpressing a T cell receptor specific for a CMV antigen and arecombinant CAR protein.

In an aspect is provided a method for forming a population of human Tcells expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen, the method including: (1) administering aviral vector encoding: (a) a CMV pp65 protein and (b) a fusion proteinincluding exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a CMV-seropositive human donor; (2) obtaining PBMCs from theCMV-seropositive human donor; (3) contacting the PBMCs with at least oneCMV antigen; (4) allowing the contacted cells to produce a population ofcells enriched for stimulated cells specific for CMV; (5) transducing atleast a portion of the enriched population of cells with a vectorexpressing a recombinant CAR protein, thereby forming a population ofhuman T cells expressing a T cell receptor specific for a CMV antigenand a recombinant CAR protein.

In an aspect is provided a method for treating a disease in a subject inneed thereof including: (i) administering to a subject a therapeuticallyeffective amount of a composition including a population of human Tcells expressing a T cell receptor specific for a viral antigen and arecombinant chimeric antigen receptor (CAR) protein, wherein therecombinant CAR protein includes: (A) an antibody region including acentral cavity formed by a heavy chain variable (VH) region, a lightchain variable (VL) region, a heavy chain constant region (CH) and alight chain constant region (CL), wherein the central cavity forms apeptide binding site including framework region amino acid residues; and(B) a transmembrane domain; and (ii) administering to the subject theviral antigen either prior to or subsequent to administering thecomposition including a population of human T cells to the subject.

In an aspect is provided a cell including a T cell receptor specific fora cytomegalovirus (CMV) antigen and a recombinant CAR protein, whereinthe recombinant CAR protein includes: (A) an antibody region including acentral cavity formed by a heavy chain variable (VH) region, a lightchain variable (VL) region, a heavy chain constant region (CH) and alight chain constant region (CL), wherein the central cavity forms apeptide binding site including framework region amino acid residues; and(B) a transmembrane domain.

In an aspect is provided a cell including a T cell receptor specific fora viral antigen and a recombinant CAR protein, wherein the recombinantCAR protein includes: (A) an antibody region including a central cavityformed by a heavy chain variable (VH) region, a light chain variable(VL) region, a heavy chain constant region (CH) and a light chainconstant region (CL), wherein the central cavity forms a peptide bindingsite including framework region amino acid residues; and (B) atransmembrane domain.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-1B. FIG. A: Schematic representation of chimeric antigenreceptors. To specifically target tumors, full mAbs or Fab fragmentsthat recognize tumor associated antigens are directly fused to thetransmembrane domain and zeta chain. In addition, the meditope bindingsite can be grafted onto the mAB/Fabs, providing an additional means ofadding functionality to CAR T cells. FIG. 1B. Since two chains have tobe expressed (e.g., the light and heavy chains of the mAb plus thetransmembrane and intracellular signaling segments), there are twodifferent possibility to express the different chains. Specifically, thelight chain followed by the heavy chain or the heavy chain followed bythe light chain.

FIGS. 2A-2B: HER2-specific CAR. FIG. 2A. Diagram of the lentiviral CARcassette for expressing the HER2-specific CAR, including the 2Aribosomal skip sequence and truncated CD19 (CD19t) which serves as aninert immunogenic marker of cell transduction. FIG. 2B. Tcm lentivirallytransduced to express HER2R:28ζ display stable cell surface expressionof both the CAR and CD19 proteins.

FIGS. 3A-3B. HER2-28ζ Tcm kill both high and low expressing HER2targets. FIG. 3A. Flow cytometry analysis evaluating HER2 surfaceexpression in a panel of breast tumor lines, and the HER2-negative U87glioblastoma cell line. FIG. 3B. 4-hour chromium release assayevaluating killing by HER2-28z CAR T cells demonstrates that both highand low-expressing HER2+ tumor lines are killed.

FIGS. 4A-4D. Meditope Studies: FIG. 4A: Crystal structure.5-Diphenyl-meditope and protein L are bound to trastuzumab memAb.Extracellular domain of HER2 defining the antigen binding site, wassuperimposed using pdb 1n8z. Note: protein L and the meditope aredistinct and distant from the antigen binding site. FIG. 4B FACS. SKBR3cells were treated with labeled trastuzumab (parental; memAb) and eithersequentially or pre-mixed with labeled meditope-protein L (MPL6). Onlythe trastuzumab memAb shifts the meditope-Protein L, indicating thatantigen binding does not preclude meditope binding. FIG. 4C Fluorescencemicroscopy. GFP fused to meditope-Protein L (MPL6-GFP) colocalizes withtrastuzumab memAb using SKBR3 cells (top row) but not with parentaltrastuzumab (bottom row). This indicates a bulky biologics does notimpair antigen binding. FIG. 4D Super resolution microscopy. IndividualHER2 receptors can be visualized and quantified using paGFP fused tomeditope-Protein L (MPL6-GFP) and trastuzumab memAb. Left panel showsentire cell. Right panel shows individual receptors.

FIG. 5 . HER2-scFv-CAR Tcm anti-tumor activity against intracranialengrafted breast tumors. Representative therapeutic responses to i.c.engrafted BT474 EGFP-ffLuc⁺ tumors (1×10⁵ cells) following intratumorali.c. injection of HER2R-CAR T cells in NSG mice. On day 11, micereceived either 1×10⁶ HER2-CAR Tcm, mock Tcm or PBS.

FIG. 6 . meHER2R-CAR T cells. Primary human T cells were lentivirallytransduced to express either the HER2-scFv-CAR (HER2R-EQ-28Z) or themeditope enabled HER2-CAR (meHER2R-dCH2-28Z). Cell surface expression ofthe meHER2-dCH2-28Z is confirmed by flow cytometry using anti-Fcantibody.

FIG. 7 . Expression of murine T84.66 and humanized M5A derivedscFv-CEA-specific CARs in Primary Human T cells. Both muT84.66 and M5Aderived CEA-scFv-CARs are stably expressed by engineered cells.

FIGS. 8A-8B. Comparing murine T84.66 versus humanized M5AscFv-CEA-specific CAR T cells for killing of CEA+ targets. FIG. 8A:Target Cell Expression of CEA. FIG. 8B: 4-hour Chromium Release Assay.muT84.66 derived CEA-scFv-CAR T cells recognize and kill CEA+ targetcells in a 4-hour chromium release assay. By comparison the humanizedM5A derived CEA-scFv-CAR T cells do not kill CEA+ Target cells.

FIG. 9 . Illustration of exemplary Fab and linker configuration.

FIG. 10 . CHO-S cells were transfected with either memAb trastuzumab FabCAR (meCAR) or trastuzumab scFv-CAR (HER2CAR) plasmid for two days. ThemeCAR and HER2CAR construct differ only in the HER2-targeting component,each linked to CH3, CD28 transmembrane domain and CD3 zeta. A truncatedCD19 can also be expressed from the plasmids and serves as atransfection control. The transfected CHO-S cells were filtered with 40μm filter to remove debris and were washed once with 0.3% BSA-PBS. Thecells were then labeled on ice for 1 h with: PE-anti-CD19 or isotypecontrol, biotinylated anti-Fcγ followed by streptavidin-PE, ordouble-labeled with Pacific Blue-soluble HER2 and Alexa Fluor488-meditope Fc (MFC). At the end of the incubations, the cells werewashed once and resuspended in 800 μl of wash buffer. Sytox blue wasadded to the unlabeled cells for viability and membrane permeabilityassessments. Cells were gated with forward and side scatter only. SytoxBlue and Pacific Blue have considerable overlap in their spectra, thusthe Sytox Blue signal of the unlabeled samples have “leaked” into thePacific Blue channel. It has been noted that when CHO-S cells expressmembrane-bound proteins, their membrane becomes more permeable to SytoxBlue dye as shown with the group of cells in yellow oval. Both meCAR-and HER2CAR-transfected cells are CD19, CH3 and sHER2 positive, but onlythe meCAR is also positive for MFC binding.

FIGS. 11A-11C. Expression of meditope-enabled Fab-CARs in primary humanT cells. FIG. 11A: Schematic of meditope (me)-enabled trastuzumabFab-CAR cassette (meHER2), with the T2A ribosomal skip sequenceseparating the antibody light chain (meLc) and the heavy chain fused tothe IgG4-CH3-Fc linker, CD28 transmembrane domain (Tm) and the CD28 andCD3ζ cytoplasmic signaling domains (Hc28ζ). Expression is driven by theEF1α promoter and was tested in two orientations: Lc-Hc28ζ and Hc28ζ-Lc.FIG. 11B: Primary human T cells were lentivirally transduced andexpression of the meHER2-CARs was evaluated by flow cytometry. Protein Lstaining, which binds the Fab light chain, confirms cell surfaceexpression of both CAR orientations, with higher expression levels (MFI)observed for the Hc28 ζ-Lc (MFI 5357) vs Lc-Hc28 ζ (MFI 2592)orientation. Meditope-AF647 staining confirms the functional formationof the CAR meditope pocket, with greater binding to the Hc28 ζ-Lc (MFI6042) vs Lc-Hc28 ((MFI 2121) orientation. FIG. 11C: meHER2-CAR T cellspre-bound to meditope peptide retain the ability to bind protein L andsoluble HER2-antigen, suggesting that meditope binding does not alterantigen binding properties and structural components of the Fab.

FIGS. 12A-12D. Meditope-enabled HER2-CAR (meHER2) T cells degranulate atcomparable levels to scFvHER2-CAR T cells in response to HER2+ targetsand meditope peptide does not negatively impact T cell degranulation.FIG. 12A: HER2+ breast cancer lines MCF-7 and SK-BR-3 were assessed forcell surface expression of HER2 by flow cytometry (Biolegend; Cat#324413). MCF-7 expresses relatively low levels of HER2 as compared toSK-BR-3 which over-expresses HER2. FIGS. 12B-12D CD107a degranulationassay. HD187.2 T cells were engineered to express eithermeHER2(Hc-Lc):28ζ CAR, meHER2 (Lc-Hc):28ζ CAR, scFvHER2:28ζ CAR or noCAR (mock). Versions of the meHER2:28ζ-CAR differ only in theorientation of the heavy chain (Hc) and light chain (Lc), see FIG. 11A.FIG. 12B: Representative FACs showing CD107a degranulation for mock Tcells (negative control) and scFvHER2-CAR T cells (positive control)following co-culture at a 1:1 effector to MCF-7 ratio (based on CARexpression) for 5 hours. CD107a degranulation (BD Pharmingen™; Cat#555800), gated on CAR+ CD8+ cells, was detected by flow cytometry(Miltenyi Biotec; MACSQuant) and analyzed using FCS Express (De NovoSoftware). FIG. 12C: meHER2(Hc-Lc):28ζ and meHER2(Lc-Hc):28ζ T cellswere incubated with and without meditope-AF647 (ME; 200 nM) anddegranulation to MCF-7 targets was evaluated as described in FIG. 12B.FIG. 12D: Bar graph depicting comparable degranulation of all meHER2 andscFvHER2-CAR T cell lines to either MCF-7 or SK-BR-3. meHER2-CAR T cellsincubated with and without meditope peptide show comparable activationas assessed by CD107a degranulation. Plotted are average and standarddeviation of three wells per condition. Cells were gated on the CD8⁺CAR⁺population.

FIGS. 13A-13B. Meditope-enabled HER2-CARs (meHER2) and scFvHER2CAR-engineered T cells kill HER2+ targets at comparable efficiency andmeditope peptide does not negatively impact T cell killing. Long termkilling assay to compare killing potency of meHER2 and scFvHER2-CAR Tcells. HD187.2 T cells were engineered to express eithermeHER2(Hc-Lc):28ζ CAR, meHER2(Lc-Hc):28ζ CAR, scFvHER2:28ζ CAR or no CAR(mock). Versions of the meHER2:28ζ-CAR differ only in the orientation ofthe heavy chain (Hc) and light chain (Lc), see FIG. 11A. HER2-CAR Tcells lines, or mock control were co-cultured with HER2⁺ breast cancerlines, MCF-7 and SKBR3, for 48-hours at a 1:4 effector to target ratio(based on CAR expression). Killing was assessed by quantifying thenumber of live tumor cells remaining after co-incubation. A viabilitystain, DAPI (Molecular Probes™; Cat #D21490) and a human leukocyteantigen, CD45 (BD Biosciences; Cat #347464), were used to exclude thedead cells and T cells from the live tumor count. meCAR-T cells wereincubated with and without meditope-AF647 (200 nM) prior to co-cultureto evaluate the impact of meditope peptide on meHER2 redirected killingpotential, FIG. 13A; Bar graph depicts the average live tumor count(DAPI-CD45−) of three replicate wells per combination. FIG. 13B: Bargraph represents the percent tumor killed per condition when normalizedto mock.

FIGS. 14A-14D depict the development of clinically feasible platform forderivation of CMV/CAR T cells and the schematic structure of alentiviral vector expressing a CD19 CAR. FIG. 14A: CMV-specific T cellsfrom CMV immune HLA A2 donors were selected using IFNγ capture afterovernight stimulation with cGMP grade CMVpp65 protein. After selection,the cells were stained with antibodies specific to IFNγ, CD4, and CD8.The frequency of each population is presented after exclusion of deadcells with DAPI. FIG. 14B: The selected cells were transduced with thesecond generation CD19CAR with a double mutation in the spacer, 24 hoursafter the IFNγ capture. 7-10 days later, the transduced cells werestimulated with irradiated CD19 expressing NIH3T3 cells at 10:1 ratio(3T3:T cells) and the stimulation was repeated 7 days post the firststimulation. CAR expression was defined by cetuximab-biotin andstreptavidin (SA) APC-Cy7 staining. Percentages of CAR⁺ cells areindicated in each histogram (filled gray), and based on subtraction ofthat stained with SA-APC-Cy7 alone (black line). FIG. 14C: Growth oftotal cell number was determined by Guava Viacount at different timepoints. FIG. 14D: Schematic diagram of 10039 nt lentiviral vectorencoding a CD19 CAR. Within the 3183 nucleotide longCD19R:CD28:z(CO)-T2A-EGFRt construct, the CD19-specific scFv, IgG4 Fcspacer, the CD28 transmembrane and cytoplasmic signaling domains,three-glycine linker, and CD3z cytoplasmic signaling domains of theCD19R:CD28:z(CO) CAR containing the 2 point mutations, L235E and N297Q,in the CH2 portion of the IgG4 spacer (CD19R(EQ)), as well as the T2Aribosome skip and truncated EGFR sequences are indicated. The humanGM-CSF receptor alpha signal sequences that drive surface translocationof the CD19R:CD28:z(CO) CAR and EGFRt are also indicated.

FIGS. 15A-15D. FIGS. 15A-15C depict the results of studies demonstratingthat CMV/CAR T cells exhibit specific effector function after engagementwith CD19⁺ and CMVpp65⁺ tumors. FIG. 15A: 7 days after the second CD19Ag stimulation, T cells were stained with HLA A2 restricted pp65tetramer, cetuximab-biotin, anti-CD8 and antibodies specific to centralmemory T cell surface markers. Percent positive cells are indicatedafter dead cell exclusion with DAPI, gating based on pp65 tetramer andcetuximab double-positivity, and isotype-matched stained samples. FIG.15B: Four-hour ⁵¹Cr release assays were performed using the CMV/CAR Tcells and indicated ⁵¹Cr-labeled target cells at differenteffector:target (E:T) ratios. OKT3-expressing LCLs were used as positivecontrols, KG1A and U251T as negative controls. CD19⁺ LCL and engineeredpp65U251T cells were used as target for CD19 and CMV-specific T cells,respectively. Data from a representative donor is presented. FIG. 15C:CMV/CAR T cells (10⁵) were activated overnight with 10⁵ LCL-OKT3, LCL,or KG1a in 96-well tissue culture plates and 10⁵ U251T and engineeredpp65 expressing U251T cells (pp65U251T) in 24-well tissue cultureplates. Supernatants were collected after overnight co-incubation ofCMV/CAR T cells and stimulators. Cytokine levels with indicatedstimulators (means±SEM of triplicate wells) were determined usingcytometric bead array. FIG. 15D depicts the results of studies examiningcytokine levels in the serum of CMV/CAR T cell treated tumor bearingmice. NSG mice were injected i.v. on day 0 with 2.5×106 GFPffluc+ LCLcells. Three days after tumor inoculation, recipient mice wereadministered i.v. with 2×106 CMV/CAR cells that underwent 2 rounds ofCD19 stimulation. Vaccine was given by i.v. injection of peptide (pp65or MP1) pulsed autologous T cells on day 14. Thirteen days post vaccine,serum of recipient mice was collected and levels of human cytokines weredetermined by cytometric bead array. Cytokine levels in the serum ofuntreated mice was used as baseline. Mean and SEMs from triplicates arepresented.

DETAILED DESCRIPTION OF THE INVENTION Definitions

While various embodiments and aspects of the present invention are shownand described herein, it will be obvious to those skilled in the artthat such embodiments and aspects are provided by way of example only.Numerous variations, changes, and substitutions will now occur to thoseskilled in the art without departing from the invention. It should beunderstood that various alternatives to the embodiments of the inventiondescribed herein may be employed in practicing the invention.

The section headings used herein are for organizational purposes onlyand are not to be construed as limiting the subject matter described.All documents, or portions of documents, cited in the applicationincluding, without limitation, patents, patent applications, articles,books, manuals, and treatises are hereby expressly incorporated byreference in their entirety for any purpose.

The abbreviations used herein have their conventional meaning within thechemical and biological arts. The chemical structures and formulae setforth herein are constructed according to the standard rules of chemicalvalency known in the chemical arts.

Where substituent groups are specified by their conventional chemicalformulae, written from left to right, they equally encompass thechemically identical substituents that would result from writing thestructure from right to left, e.g., —CH₂O— is equivalent to —OCH₂—.

The term “alkyl,” by itself or as part of another substituent, means,unless otherwise stated, a straight (i.e., unbranched) or branchednon-cyclic carbon chain (or carbon), or combination thereof, which maybe fully saturated, mono- or polyunsaturated and can include di- andmultivalent radicals, having the number of carbon atoms designated(i.e., C₁-C₁₀ means one to ten carbons). Examples of saturatedhydrocarbon radicals include, but are not limited to, groups such asmethyl, ethyl, n-propyl, isopropyl, n-butyl, t-butyl, isobutyl,sec-butyl, (cyclohexyl)methyl, homologs and isomers of, for example,n-pentyl, n-hexyl, n-heptyl, n-octyl and the like. An unsaturated alkylgroup is one having one or more double bonds or triple bonds. Examplesof unsaturated alkyl groups include, but are not limited to, vinyl,2-propenyl, crotyl, 2-isopentenyl, 2-(butadienyl), 2,4-pentadienyl,3-(1,4-pentadienyl), ethynyl, 1- and 3-propynyl, 3-butynyl, and thehigher homologs and isomers. An alkoxy is an alkyl attached to theremainder of the molecule via an oxygen linker (—O—). An alkyl moietymay be an alkenyl moiety. An alkyl moiety may be an alkynyl moiety. Analkyl moiety may be fully saturated.

The term “alkylene,” by itself or as part of another substituent, means,unless otherwise stated, a divalent radical derived from an alkyl, asexemplified, but not limited by, —CH₂CH₂CH₂CH₂—. Typically, an alkyl (oralkylene) group will have from 1 to 24 carbon atoms, with those groupshaving 10 or fewer carbon atoms being preferred in the presentinvention. A “lower alkyl” or “lower alkylene” is a shorter chain alkylor alkylene group, generally having eight or fewer carbon atoms. Theterm “alkenylene,” by itself or as part of another substituent, means,unless otherwise stated, a divalent radical derived from an alkene.

The term “heteroalkyl,” by itself or in combination with another term,means, unless otherwise stated, a stable non-cyclic straight or branchedchain, or combinations thereof, including at least one carbon atom andat least one heteroatom (e.g. O, N, P, Si or S) and wherein the nitrogenand sulfur atoms may optionally be oxidized, and the nitrogen heteroatommay optionally be quaternized. The heteroatom(s) O, N, P, S, and Si maybe placed at any interior position of the heteroalkyl group or at theposition at which the alkyl group is attached to the remainder of themolecule. Examples include, but are not limited to: —CH₂—CH₂—O—CH₃,—CH₂—CH₂—NH—CH₃, —CH₂—CH₂—N(CH₃)—CH₃, —CH₂—S—CH₂—CH₃, —CH₂—CH₂,—S(O)—CH₃, —CH₂—CH₂—S(O)₂—CH₃, —CH═CHO—CH₃, —Si(CH₃)₃, —CH₂—CH═N—OCH₃,—C—H═CH—N(CH₃)—CH₃, —O—CH₃, —O—CH₂—CH₃, and —CN. Up to two or threeheteroatoms may be consecutive, such as, for example, —CH₂—NH—OCH₃ and—CH₂—O—Si(CH₃)₃. A heteroalkyl moiety may include one heteroatom (e.g.,O, N, S, Si, or P). A heteroalkyl moiety may include two optionallydifferent heteroatoms (e.g., O, N, S, Si, or P). A heteroalkyl moietymay include three optionally different heteroatoms (e.g., O, N, S, Si,or P). A heteroalkyl moiety may include four optionally differentheteroatoms (e.g., O, N, S, Si, or P). A heteroalkyl moiety may includefive optionally different heteroatoms (e.g., O, N, S, Si, or P). Aheteroalkyl moiety may include up to 8 optionally different heteroatoms(e.g., O, N, S, Si, or P).

Similarly, the term “heteroalkylene,” by itself or as part of anothersubstituent, means, unless otherwise stated, a divalent radical derivedfrom heteroalkyl, as exemplified, but not limited by,—CH₂—CH₂—S—CH₂—CH₂— and —CH₂—S—CH₂—CH₂—NH—CH₂—. For heteroalkylenegroups, heteroatoms can also occupy either or both of the chain termini(e.g., alkyleneoxy, alkylenedioxy, alkyleneamino, alkylenediamino, andthe like). Still further, for alkylene and heteroalkylene linkinggroups, no orientation of the linking group is implied by the directionin which the formula of the linking group is written. For example, theformula —C(O)₂R′— represents both —C(O)₂R′— and —R′C(O)₂—. As describedabove, heteroalkyl groups, as used herein, include those groups that areattached to the remainder of the molecule through a heteroatom, such as—C(O)R′, —C(O)NR′, —NR′R″, —OR′, —SR′, and/or —SO₂R′. Where“heteroalkyl” is recited, followed by recitations of specificheteroalkyl groups, such as —NR′R″ or the like, it will be understoodthat the terms heteroalkyl and —NR′R″ are not redundant or mutuallyexclusive. Rather, the specific heteroalkyl groups are recited to addclarity. Thus, the term “heteroalkyl” should not be interpreted hereinas excluding specific heteroalkyl groups, such as —NR′R″ or the like.

The terms “cycloalkyl” and “heterocycloalkyl,” by themselves or incombination with other terms, mean, unless otherwise stated,non-aromatic cyclic versions of “alkyl” and “heteroalkyl,” respectively,wherein the carbons making up the ring or rings do not necessarily needto be bonded to a hydrogen due to all carbon valencies participating inbonds with non-hydrogen atoms. Additionally, for heterocycloalkyl, aheteroatom can occupy the position at which the heterocycle is attachedto the remainder of the molecule. Examples of cycloalkyl include, butare not limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl,1-cyclohexenyl, 3-cyclohexenyl, cycloheptyl,3-hydroxy-cyclobut-3-enyl-1,2, dione, 1H-1,2,4-triazolyl-5(4H)-one,4H-1,2,4-triazolyl, and the like. Examples of heterocycloalkyl include,but are not limited to, 1-(1,2,5,6-tetrahydropyridyl), 1-piperidinyl,2-piperidinyl, 3-piperidinyl, 4-morpholinyl, 3-morpholinyl,tetrahydrofuran-2-yl, tetrahydrofuran-3-yl, tetrahydrothien-2-yl,tetrahydrothien-3-yl, 1-piperazinyl, 2-piperazinyl, and the like. A“cycloalkylene” and a “heterocycloalkylene,” alone or as part of anothersubstituent, means a divalent radical derived from a cycloalkyl andheterocycloalkyl, respectively. A heterocycloalkyl moiety may includeone ring heteroatom (e.g., O, N, S, Si, or P). A heterocycloalkyl moietymay include two optionally different ring heteroatoms (e.g., O, N, S,Si, or P). A heterocycloalkyl moiety may include three optionallydifferent ring heteroatoms (e.g., O, N, S, Si, or P). A heterocycloalkylmoiety may include four optionally different ring heteroatoms (e.g., O,N, S, Si, or P). A heterocycloalkyl moiety may include five optionallydifferent ring heteroatoms (e.g., O, N, S, Si, or P). A heterocycloalkylmoiety may include up to 8 optionally different ring heteroatoms (e.g.,O, N, S, Si, or P).

The terms “halo” or “halogen,” by themselves or as part of anothersubstituent, mean, unless otherwise stated, a fluorine, chlorine,bromine, or iodine atom. Additionally, terms such as “haloalkyl” aremeant to include monohaloalkyl and polyhaloalkyl. For example, the term“halo(C₁-C₄)alkyl” includes, but is not limited to, fluoromethyl,difluoromethyl, trifluoromethyl, 2,2,2-trifluoroethyl, 4-chlorobutyl,3-bromopropyl, and the like.

The term “acyl” means, unless otherwise stated, —C(O)R where R is asubstituted or unsubstituted alkyl, substituted or unsubstitutedcycloalkyl, substituted or unsubstituted heteroalkyl, substituted orunsubstituted heterocycloalkyl, substituted or unsubstituted aryl, orsubstituted or unsubstituted heteroaryl.

The term “aryl” means, unless otherwise stated, a polyunsaturated,aromatic, hydrocarbon substituent, which can be a single ring ormultiple rings (preferably from 1 to 3 rings) that are fused together(i.e., a fused ring aryl) or linked covalently. A fused ring aryl refersto multiple rings fused together wherein at least one of the fused ringsis an aryl ring. The term “heteroaryl” refers to aryl groups (or rings)that contain at least one heteroatom such as N, O, or S, wherein thenitrogen and sulfur atoms are optionally oxidized, and the nitrogenatom(s) are optionally quaternized. Thus, the term “heteroaryl” includesfused ring heteroaryl groups (i.e., multiple rings fused togetherwherein at least one of the fused rings is a heteroaromatic ring). A5,6-fused ring heteroarylene refers to two rings fused together, whereinone ring has 5 members and the other ring has 6 members, and wherein atleast one ring is a heteroaryl ring. Likewise, a 6,6-fused ringheteroarylene refers to two rings fused together, wherein one ring has 6members and the other ring has 6 members, and wherein at least one ringis a heteroaryl ring. And a 6,5-fused ring heteroarylene refers to tworings fused together, wherein one ring has 6 members and the other ringhas 5 members, and wherein at least one ring is a heteroaryl ring. Aheteroaryl group can be attached to the remainder of the moleculethrough a carbon or heteroatom. Non-limiting examples of aryl andheteroaryl groups include phenyl, 1-naphthyl, 2-naphthyl, 4-biphenyl,1-pyrrolyl, 2-pyrrolyl, 3-pyrrolyl, 3-pyrazolyl, 2-imidazolyl,4-imidazolyl, pyrazinyl, 2-oxazolyl, 4-oxazolyl, 2-phenyl-4-oxazolyl,5-oxazolyl, 3-isoxazolyl, 4-isoxazolyl, 5-isoxazolyl, 2-thiazolyl,4-thiazolyl, 5-thiazolyl, 2-furyl, 3-furyl, 2-thienyl, 3-thienyl,2-pyridyl, 3-pyridyl, 4-pyridyl, 2-pyrimidyl, 4-pyrimidyl,5-benzothiazolyl, purinyl, 2-benzimidazolyl, 5-indolyl, 1-isoquinolyl,5-isoquinolyl, 2-quinoxalinyl, 5-quinoxalinyl, 3-quinolyl, and6-quinolyl. Substituents for each of the above noted aryl and heteroarylring systems are selected from the group of acceptable substituentsdescribed below. An “arylene” and a “heteroarylene,” alone or as part ofanother substituent, mean a divalent radical derived from an aryl andheteroaryl, respectively. Non-limiting examples of aryl and heteroarylgroups include pyridinyl, pyrimidinyl, thiophenyl, thienyl, furanyl,indolyl, benzoxadiazolyl, benzodioxolyl, benzodioxanyl, thianaphthanyl,pyrrolopyridinyl, indazolyl, quinolinyl, quinoxalinyl, pyridopyrazinyl,quinazolinonyl, benzoisoxazolyl, imidazopyridinyl, benzofuranyl,benzothienyl, benzothiophenyl, phenyl, naphthyl, biphenyl, pyrrolyl,pyrazolyl, imidazolyl, pyrazinyl, oxazolyl, isoxazolyl, thiazolyl,furylthienyl, pyridyl, pyrimidyl, benzothiazolyl, purinyl,benzimidazolyl, isoquinolyl, thiadiazolyl, oxadiazolyl, pyrrolyl,diazolyl, triazolyl, tetrazolyl, benzothiadiazolyl, isothiazolyl,pyrazolopyrimidinyl, pyrrolopyrimidinyl, benzotriazolyl, benzoxazolyl,or quinolyl. The examples above may be substituted or unsubstituted anddivalent radicals of each heteroaryl example above are non-limitingexamples of heteroarylene. A heteroaryl moiety may include one ringheteroatom (e.g., O, N, or S). A heteroaryl moiety may include twooptionally different ring heteroatoms (e.g., O, N, or S). A heteroarylmoiety may include three optionally different ring heteroatoms (e.g., O,N, or S). A heteroaryl moiety may include four optionally different ringheteroatoms (e.g., O, N, or S). A heteroaryl moiety may include fiveoptionally different ring heteroatoms (e.g., O, N, or S). An aryl moietymay have a single ring. An aryl moiety may have two optionally differentrings. An aryl moiety may have three optionally different rings. An arylmoiety may have four optionally different rings. A heteroaryl moiety mayhave one ring. A heteroaryl moiety may have two optionally differentrings. A heteroaryl moiety may have three optionally different rings. Aheteroaryl moiety may have four optionally different rings. A heteroarylmoiety may have five optionally different rings.

A fused ring heterocycloalkyl-aryl is an aryl fused to aheterocycloalkyl. A fused ring heterocycloalkyl-heteroaryl is aheteroaryl fused to a heterocycloalkyl. A fused ringheterocycloalkyl-cycloalkyl is a heterocycloalkyl fused to a cycloalkyl.A fused ring heterocycloalkyl-heterocycloalkyl is a heterocycloalkylfused to another heterocycloalkyl. Fused ring heterocycloalkyl-aryl,fused ring heterocycloalkyl-heteroaryl, fused ringheterocycloalkyl-cycloalkyl, or fused ringheterocycloalkyl-heterocycloalkyl may each independently beunsubstituted or substituted with one or more of the substituentsdescribed herein.

The term “oxo,” as used herein, means an oxygen that is double bonded toa carbon atom.

The term “alkylsulfonyl,” as used herein, means a moiety having theformula —S(O₂)—R′, where R′ is a substituted or unsubstituted alkylgroup as defined above. R′ may have a specified number of carbons (e.g.,“C₁-C₄ alkylsulfonyl”).

Each of the above terms (e.g., “alkyl,” “heteroalkyl,”, “cycloalkyl”,“heterocycloalkyl”, “aryl,” and “heteroaryl”) includes both substitutedand unsubstituted forms of the indicated radical. Preferred substituentsfor each type of radical are provided below.

Substituents for the alkyl and heteroalkyl radicals (including thosegroups often referred to as alkylene, alkenyl, heteroalkylene,heteroalkenyl, alkynyl, cycloalkyl, heterocycloalkyl, cycloalkenyl, andheterocycloalkenyl) can be one or more of a variety of groups selectedfrom, but not limited to, —OR′, ═O, ═NR′, ═N—OR′, —NR′R″, —SR′,-halogen, —SiR′R″R′″, —OC(O)R′, —C(O)R′, —CO₂R′, —CONR′R″, —OC(O)NR′R″,—NR″C(O)R′, —NR′—C(O)NR″R′″, —NR″C(O)₂R′, —NR—C(NR′R″)═NR′″, —S(O)R′,—S(O)₂R′, —S(O)₂N(R)(‘R″—NRSO₂R′), —CN, and —NO₂ in a number rangingfrom zero to (2m′+1), where m′ is the total number of carbon atoms insuch radical. R′, R″, R′″, and R″″ each preferably independently referto hydrogen, substituted or unsubstituted heteroalkyl, substituted orunsubstituted cycloalkyl, substituted or unsubstituted heterocycloalkyl,substituted or unsubstituted aryl (e.g., aryl substituted with 1-3halogens), substituted or unsubstituted alkyl, alkoxy, or thioalkoxygroups, or arylalkyl groups. When a compound of the invention includesmore than one R group, for example, each of the R groups isindependently selected as are each R′, R″, R′″, and R″″ group when morethan one of these groups is present. When R′ and R″ are attached to thesame nitrogen atom, they can be combined with the nitrogen atom to forma 4-, 5-, 6-, or 7-membered ring. For example, —NR′R″ includes, but isnot limited to, 1-pyrrolidinyl and 4-morpholinyl. From the abovediscussion of substituents, one of skill in the art will understand thatthe term “alkyl” is meant to include groups including carbon atoms boundto groups other than hydrogen groups, such as haloalkyl (e.g., —CF₃ and—CH₂CF₃) and acyl (e.g., —C(O)CH₃, —C(O)CF₃, —C(O)CH₂OCH₃, and thelike).

Similar to the substituents described for the alkyl radical,substituents for the aryl and heteroaryl groups are varied and areselected from, for example: —OR′, —NR′R″, —SR′, -halogen, —SiR′R″R′″,—OC(O)R′, —C(O)R′, —CO₂R′, —CONR′R″, —OC(O)NR′R″, —NR″C(O)R′,—NR′—C(O)NR″R′″, NR″C(O)₂R′, NRC(NR′R″)═NR′″, S(O)R′, —S(O)₂R′,—S(O)₂N(R′)(R″, —NRSO₂R′), —CN, —NO₂, —R′, —N₃, —CH(Ph)₂,fluoro(C₁-C₄)alkoxy, and fluoro(C₁-C₄)alkyl, in a number ranging fromzero to the total number of open valences on the aromatic ring system;and where R′, R″, R′″, and R″″ are preferably independently selectedfrom hydrogen, substituted or unsubstituted alkyl, substituted orunsubstituted heteroalkyl, substituted or unsubstituted cycloalkyl,substituted or unsubstituted heterocycloalkyl, substituted orunsubstituted aryl, and substituted or unsubstituted heteroaryl. When acompound of the invention includes more than one R group, for example,each of the R groups is independently selected as are each R′, R″, R′″,and R″″ groups when more than one of these groups is present.

Where a moiety is substituted with an R substituent, the group may bereferred to as “R-substituted.” Where a moiety is R-substituted, themoiety is substituted with at least one R substituent and each Rsubstituent is optionally different. For example, where a moiety hereinis R^(1A)-substituted or unsubstituted alkyl, a plurality of R^(1A)substituents may be attached to the alkyl moiety wherein each R^(1A)substituent is optionally different. Where an R-substituted moiety issubstituted with a plurality R substituents, each of the R-substituentsmay be differentiated herein using a prime symbol (′) such as R′, R″,etc. For example, where a moiety is R^(3A)-substituted or unsubstitutedalkyl, and the moiety is substituted with a plurality of R^(3A)substituents, the plurality of R^(3A) substituents may be differentiatedas R^(3A′)′, R^(3A)″, R^(3A)′″, etc. In some embodiments, the pluralityof R substituents is 3. In some embodiments, the plurality of Rsubstituents is 2.

Two or more substituents may optionally be joined to form aryl,heteroaryl, cycloalkyl, or heterocycloalkyl groups. Such so-calledring-forming substituents are typically, though not necessarily, foundattached to a cyclic base structure. In one embodiment, the ring-formingsubstituents are attached to adjacent members of the base structure. Forexample, two ring-forming substituents attached to adjacent members of acyclic base structure create a fused ring structure. In anotherembodiment, the ring-forming substituents are attached to a singlemember of the base structure. For example, two ring-forming substituentsattached to a single member of a cyclic base structure create aspirocyclic structure. In yet another embodiment, the ring-formingsubstituents are attached to non-adjacent members of the base structure.

Two of the substituents on adjacent atoms of the aryl or heteroaryl ringmay optionally form a ring of the formula -T-C(O)—(CRR′)_(q)-U-, whereinT and U are independently —NR—, —O—, —CRR′—, or a single bond, and q isan integer of from 0 to 3. Alternatively, two of the substituents onadjacent atoms of the aryl or heteroaryl ring may optionally be replacedwith a substituent of the formula -A-(CH₂)_(r)-B-, wherein A and B areindependently —CRR′—, —O—, —NR—, —S—, —S(O)—, —S(O)₂—, —S(O)₂NR′—, or asingle bond, and r is an integer of from 1 to 4. One of the single bondsof the new ring so formed may optionally be replaced with a double bond.Alternatively, two of the substituents on adjacent atoms of the aryl orheteroaryl ring may optionally be replaced with a substituent of theformula —(CRR′)_(s)—X′—(C″R″R′″)_(d)—, where variables s and d areindependently integers of from 0 to 3, and X′ is —O—, —NR′—, —S—,—S(O)—, —S(O)₂—, or —S(O)₂NR′—. The substituents R, R′, R″, and R′″ arepreferably independently selected from hydrogen, substituted orunsubstituted alkyl, substituted or unsubstituted heteroalkyl,substituted or unsubstituted cycloalkyl, substituted or unsubstitutedheterocycloalkyl, substituted or unsubstituted aryl, and substituted orunsubstituted heteroaryl.

As used herein, the terms “heteroatom” or “ring heteroatom” are meant toinclude, oxygen (O), nitrogen (N), sulfur (S), phosphorus (P), andsilicon (Si).

A “substituent group,” as used herein, means a group selected from thefollowing moieties:

-   -   (A) oxo, halogen, —CF₃, —CN, —OH, —NH₂, —COOH, —CONH₂, —NO₂,        —SH, —SO₂Cl, —SO₃H, —SO₄H, —SO₂NH₂, —NHNH₂, —ONH₂,        —NHC═(O)NHNH₂, —NHC═(O) NH₂, —NHSO₂H, —NHC═(O)H, —NHC(O)—OH,        —NHOH, —OCF₃, —OCHF₂, unsubstituted alkyl, unsubstituted        heteroalkyl, unsubstituted cycloalkyl, unsubstituted        heterocycloalkyl, unsubstituted aryl, unsubstituted heteroaryl,        and    -   (B) alkyl, heteroalkyl, cycloalkyl, heterocycloalkyl, aryl,        heteroaryl, substituted with at least one substituent selected        from:        -   (i) oxo, halogen, —CF₃, —CN, —OH, —NH₂, —COOH, —CONH₂, —NO₂,            —SH, —SO₂Cl, —SO₃H, —SO₄H, —SO₂NH₂, —NHNH₂, —ONH₂,            —NHC═(O)NHNH₂, —NHC═(O) NH₂, —NHSO₂H, —NHC═(O)H, —NHC(O)—OH,            —NHOH, —OCF₃, —OCHF₂, unsubstituted alkyl, unsubstituted            heteroalkyl, unsubstituted cycloalkyl, unsubstituted            heterocycloalkyl, unsubstituted aryl, unsubstituted            heteroaryl, and        -   (ii) alkyl, heteroalkyl, cycloalkyl, heterocycloalkyl, aryl,            heteroaryl, substituted with at least one substituent            selected from:            -   (a) oxo, halogen, —CF₃, —CN, —OH, —NH₂, —COOH, —CONH₂,                —NO₂, —SH, —SO₂Cl, —SO₃H, —SO₄H, —SO₂NH₂, —NHNH₂, —ONH₂,                —NHC═(O)NHNH₂, —NHC═(O) NH₂, —NHSO₂H, —NHC═(O)H,                —NHC(O)—OH, —NHOH, —OCF₃, —OCHF₂, unsubstituted alkyl,                unsubstituted heteroalkyl, unsubstituted cycloalkyl,                unsubstituted heterocycloalkyl, unsubstituted aryl,                unsubstituted heteroaryl, and            -   (b) alkyl, heteroalkyl, cycloalkyl, heterocycloalkyl,                aryl, heteroaryl, substituted with at least one                substituent selected from: oxo,        -   halogen, —CF₃, —CN, —OH, —NH₂, —COOH, —CONH₂, —NO₂, —SH,            —SO₂Cl, —SO₃H, —SO₄H, —SO₂NH₂, —NHNH₂, —ONH₂, —NHC═(O)NHNH₂,            —NHC═(O) NH₂, —NHSO₂H, —NHC═(O)H, —NHC(O)—OH, —NHOH, —OCF₃,            —OCHF₂, unsubstituted alkyl, unsubstituted heteroalkyl,            unsubstituted cycloalkyl, unsubstituted heterocycloalkyl,            unsubstituted aryl, unsubstituted heteroaryl.

A “size-limited substituent” or “size-limited substituent group,” asused herein, means a group selected from all of the substituentsdescribed above for a “substituent group,” wherein each substituted orunsubstituted alkyl is a substituted or unsubstituted C₁-C₂₀ alkyl, eachsubstituted or unsubstituted heteroalkyl is a substituted orunsubstituted 2 to 20 membered heteroalkyl, each substituted orunsubstituted cycloalkyl is a substituted or unsubstituted C₃-C₈cycloalkyl, each substituted or unsubstituted heterocycloalkyl is asubstituted or unsubstituted 3 to 8 membered heterocycloalkyl, eachsubstituted or unsubstituted aryl is a substituted or unsubstitutedC₆-C₁₀ aryl, and each substituted or unsubstituted heteroaryl is asubstituted or unsubstituted 5 to 10 membered heteroaryl.

A “lower substituent” or “lower substituent group,” as used herein,means a group selected from all of the substituents described above fora “substituent group,” wherein each substituted or unsubstituted alkylis a substituted or unsubstituted C₁-C₈ alkyl, each substituted orunsubstituted heteroalkyl is a substituted or unsubstituted 2 to 8membered heteroalkyl, each substituted or unsubstituted cycloalkyl is asubstituted or unsubstituted C₃-C₇ cycloalkyl, each substituted orunsubstituted heterocycloalkyl is a substituted or unsubstituted 3 to 7membered heterocycloalkyl, each substituted or unsubstituted aryl is asubstituted or unsubstituted C₆-C₁₀ aryl, and each substituted orunsubstituted heteroaryl is a substituted or unsubstituted 5 to 9membered heteroaryl.

In some embodiments, each substituted group described in the compoundsherein is substituted with at least one substituent group. Morespecifically, in some embodiments, each substituted alkyl, substitutedheteroalkyl, substituted cycloalkyl, substituted heterocycloalkyl,substituted aryl, substituted heteroaryl, substituted alkylene,substituted heteroalkylene, substituted cycloalkylene, substitutedheterocycloalkylene, substituted arylene, and/or substitutedheteroarylene described in the compounds herein are substituted with atleast one substituent group. In other embodiments, at least one or allof these groups are substituted with at least one size-limitedsubstituent group. In other embodiments, at least one or all of thesegroups are substituted with at least one lower substituent group.

In other embodiments of the compounds herein, each substituted orunsubstituted alkyl may be a substituted or unsubstituted C₁-C₂₀ alkyl,each substituted or unsubstituted heteroalkyl is a substituted orunsubstituted 2 to 20 membered heteroalkyl, each substituted orunsubstituted cycloalkyl is a substituted or unsubstituted C₃-C₈cycloalkyl, each substituted or unsubstituted heterocycloalkyl is asubstituted or unsubstituted 3 to 8 membered heterocycloalkyl, eachsubstituted or unsubstituted aryl is a substituted or unsubstitutedC₆-C₁₀ aryl, and/or each substituted or unsubstituted heteroaryl is asubstituted or unsubstituted 5 to 10 membered heteroaryl. In someembodiments of the compounds herein, each substituted or unsubstitutedalkylene is a substituted or unsubstituted C₁-C₂₀ alkylene, eachsubstituted or unsubstituted heteroalkylene is a substituted orunsubstituted 2 to 20 membered heteroalkylene, each substituted orunsubstituted cycloalkylene is a substituted or unsubstituted C₃-C₈cycloalkylene, each substituted or unsubstituted heterocycloalkylene isa substituted or unsubstituted 3 to 8 membered heterocycloalkylene, eachsubstituted or unsubstituted arylene is a substituted or unsubstitutedC₆-C₁₀ arylene, and/or each substituted or unsubstituted heteroaryleneis a substituted or unsubstituted 5 to 10 membered heteroarylene.

In some embodiments, each substituted or unsubstituted alkyl is asubstituted or unsubstituted C₁-C₈ alkyl, each substituted orunsubstituted heteroalkyl is a substituted or unsubstituted 2 to 8membered heteroalkyl, each substituted or unsubstituted cycloalkyl is asubstituted or unsubstituted C₃-C₇ cycloalkyl, each substituted orunsubstituted heterocycloalkyl is a substituted or unsubstituted 3 to 7membered heterocycloalkyl, each substituted or unsubstituted aryl is asubstituted or unsubstituted C₆-C₁₀ aryl, and/or each substituted orunsubstituted heteroaryl is a substituted or unsubstituted 5 to 9membered heteroaryl. In some embodiments, each substituted orunsubstituted alkylene is a substituted or unsubstituted C₁-C₈ alkylene,each substituted or unsubstituted heteroalkylene is a substituted orunsubstituted 2 to 8 membered heteroalkylene, each substituted orunsubstituted cycloalkylene is a substituted or unsubstituted C₃-C₇cycloalkylene, each substituted or unsubstituted heterocycloalkylene isa substituted or unsubstituted 3 to 7 membered heterocycloalkylene, eachsubstituted or unsubstituted arylene is a substituted or unsubstitutedC₆-C₁₀ arylene, and/or each substituted or unsubstituted heteroaryleneis a substituted or unsubstituted 5 to 9 membered heteroarylene. In someembodiments, the compound is a chemical species set forth in theExamples section, figures, or tables below.

As used herein, the term “conjugate” refers to the association betweenatoms or molecules. The association can be direct or indirect. Forexample, a conjugate between a nucleic acid and a protein can be direct,e.g., by covalent bond, or indirect, e.g., by non-covalent bond (e.g.electrostatic interactions (e.g. ionic bond, hydrogen bond, halogenbond), van der Waals interactions (e.g. dipole-dipole, dipole-induceddipole, London dispersion), ring stacking (pi effects), hydrophobicinteractions and the like). In embodiments, conjugates are formed usingconjugate chemistry including, but are not limited to nucleophilicsubstitutions (e.g., reactions of amines and alcohols with acyl halides,active esters), electrophilic substitutions (e.g., enamine reactions)and additions to carbon-carbon and carbon-heteroatom multiple bonds(e.g., Michael reaction, Diels-Alder addition). These and other usefulreactions are discussed in, for example, March, ADVANCED ORGANICCHEMISTRY, 3rd Ed., John Wiley & Sons, New York, 1985; Hermanson,BIOCONJUGATE TECHNIQUES, Academic Press, San Diego, 1996; and Feeney etal., MODIFICATION OF PROTEINS; Advances in Chemistry Series, Vol. 198,American Chemical Society, Washington, D.C., 1982.

Useful reactive moieties or functional groups used for conjugatechemistries (including “click chemistries” as known in the art) hereininclude, for example:

(a) carboxyl groups and various derivatives thereof including, but notlimited to, N-hydroxysuccinimide esters, N-hydroxybenztriazole esters,acid halides, acyl imidazoles, thioesters, p-nitrophenyl esters, alkyl,alkenyl, alkynyl and aromatic esters;

(b) hydroxyl groups which can be converted to esters, ethers, aldehydes,etc.

(c) haloalkyl groups wherein the halide can be later displaced with anucleophilic group such as, for example, an amine, a carboxylate anion,thiol anion, carbanion, or an alkoxide ion, thereby resulting in thecovalent attachment of a new group at the site of the halogen atom;

(d) dienophile groups which are capable of participating in Diels-Alderreactions such as, for example, maleimido groups;

(e) aldehyde or ketone groups such that subsequent derivatization ispossible via formation of carbonyl derivatives such as, for example,imines, hydrazones, semicarbazones or oximes, or via such mechanisms asGrignard addition or alkyllithium addition;

(f) sulfonyl halide groups for subsequent reaction with amines, forexample, to form sulfonamides;

(g) thiol groups, which can be converted to disulfides, reacted withacyl halides, or bonded to metals such as gold;

(h) amine or sulfhydryl groups, which can be, for example, acylated,alkylated or oxidized;

(i) alkenes, which can undergo, for example, cycloadditions, acylation,Michael addition, etc.;

(j) epoxides, which can react with, for example, amines and hydroxylcompounds;

(k) phosphoramidites and other standard functional groups useful innucleic acid synthesis;

(l) metal silicon oxide bonding;

(m) metal bonding to reactive phosphorus groups (e.g. phosphines) toform, for example, phosphate diester bonds; and

(n) sulfones, for example, vinyl sulfone.

Chemical synthesis of compositions by joining small modular units usingconjugate (“click”) chemistry is well known in the art and described,for example, in H. C. Kolb, M. G. Finn and K. B. Sharpless ((2001).“Click Chemistry: Diverse Chemical Function from a Few Good Reactions”.Angewandte Chemie International Edition 40 (11): 2004-2021); R. A. Evans((2007). “The Rise of Azide-Alkyne 1,3-Dipolar ‘Click’ Cycloaddition andits Application to Polymer Science and Surface Modification”. AustralianJournal of Chemistry 60 (6): 384-395; W. C. Guida et al. Med. Res. Rev.p 3 1996; Spiteri, Christian and Moses, John E. ((2010).“Copper-Catalyzed Azide-Alkyne Cycloaddition: Regioselective Synthesisof 1,4,5-Trisubstituted 1,2,3-Triazoles”. Angewandte ChemieInternational Edition 49 (1): 31-33); Hoyle, Charles E. and Bowman,Christopher N. ((2010). “Thiol-Ene Click Chemistry”. Angewandte ChemieInternational Edition 49 (9): 1540-1573); Blackman, Melissa L. andRoyzen, Maksim and Fox, Joseph M. ((2008). “Tetrazine Ligation: FastBioconjugation Based on Inverse-Electron-Demand Diels-Alder Reactivity”.Journal of the American Chemical Society 130 (41): 13518-13519);Devaraj, Neal K. and Weissleder, Ralph and Hilderbrand, Scott A.((2008). “Tetrazine Based Cycloadditions: Application to PretargetedLive Cell Labeling”. Bioconjugate Chemistry 19 (12): 2297-2299);Stockmann, Henning; Neves, Andre; Stairs, Shaun; Brindle, Kevin; Leeper,Finian ((2011). “Exploring isonitrile-based click chemistry for ligationwith biomolecules”. Organic & Biomolecular Chemistry), all of which arehereby incorporated by reference in their entirety and for all purposes.

The reactive functional groups can be chosen such that they do notparticipate in, or interfere with, the chemical stability of theproteins or nucleic acids described herein. By way of example, thenucleic acids can include a vinyl sulfone or other reactive moiety(e.g., maleimide). Optionally, the nucleic acids can include a reactivemoiety having the formula —S—S—R. R can be, for example, a protectinggroup. Optionally, R is hexanol. As used herein, the term hexanolincludes compounds with the formula C₆H₁₃OH and includes, 1-hexanol,2-hexanol, 3-hexanol, 2-methyl-1-pentanol, 3-methyl-1-pentanol,4-methyl-1-pentanol, 2-methyl-2-pentanol, 3-methyl-2-pentanol,4-methyl-2-pentanol, 2-methyl-3-pentanol, 3-methyl-3-pentanol,2,2-dimethyl-1-butanol, 2,3-dimethyl-1-butanol, 3,3-dimethyl-1-butanol,2,3-dimethyl-2-butanol, 3,3-dimethyl-2-butanol, and 2-ethyl-1-butanol.Optionally, R is 1-hexanol.

As used herein, the term “about” means a range of values including thespecified value, which a person of ordinary skill in the art wouldconsider reasonably similar to the specified value. In embodiments, theterm “about” means within a standard deviation using measurementsgenerally acceptable in the art. In embodiments, about means a rangeextending to +/−10% of the specified value. In embodiments, about meansthe specified value.

The terms “a” or “an,” as used in herein means one or more. In addition,the phrase “substituted with a[n],” as used herein, means the specifiedgroup may be substituted with one or more of any or all of the namedsubstituents. For example, where a group, such as an alkyl or heteroarylgroup, is “substituted with an unsubstituted C₁-C₂₀ alkyl, orunsubstituted 2 to 20 membered heteroalkyl,” the group may contain oneor more unsubstituted C₁-C₂₀ alkyls, and/or one or more unsubstituted 2to 20 membered heteroalkyls. Moreover, where a moiety is substitutedwith an R substituent, the group may be referred to as “R-substituted.”Where a moiety is R-substituted, the moiety is substituted with at leastone R substituent and each R substituent is optionally different.

Unless defined otherwise, technical and scientific terms used hereinhave the same meaning as commonly understood by a person of ordinaryskill in the art. See, e.g., Singleton et al., DICTIONARY OFMICROBIOLOGY AND MOLECULAR BIOLOGY 2nd ed., J. Wiley & Sons (New York,N.Y. 1994); Sambrook et al., MOLECULAR CLONING, A LABORATORY MANUAL,Cold Springs Harbor Press (Cold Springs Harbor, N Y 1989). Any methods,devices and materials similar or equivalent to those described hereincan be used in the practice of this invention. The following definitionsare provided to facilitate understanding of certain terms usedfrequently herein and are not meant to limit the scope of the presentdisclosure.

“Biological sample” or “sample” refer to materials obtained from orderived from a subject or patient. A biological sample includes sectionsof tissues such as biopsy and autopsy samples, and frozen sections takenfor histological purposes. Such samples include bodily fluids such asblood and blood fractions or products (e.g., serum, plasma, platelets,red blood cells, and the like), sputum, tissue, cultured cells (e.g.,primary cultures, explants, and transformed cells) stool, urine,synovial fluid, joint tissue, synovial tissue, synoviocytes,fibroblast-like synoviocytes, macrophage-like synoviocytes, immunecells, hematopoietic cells, fibroblasts, macrophages, T cells, etc. Abiological sample is typically obtained from a eukaryotic organism, suchas a mammal such as a primate e.g., chimpanzee or human; cow; dog; cat;a rodent, e.g., guinea pig, rat, mouse; rabbit; or a bird; reptile; orfish.

A “cell” as used herein, refers to a cell carrying out metabolic orother functions sufficient to preserve or replicate its genomic DNA. Acell can be identified by well-known methods in the art including, forexample, presence of an intact membrane, staining by a particular dye,ability to produce progeny or, in the case of a gamete, ability tocombine with a second gamete to produce a viable offspring. Cells mayinclude prokaryotic and eukaryotic cells. Prokaryotic cells include butare not limited to bacteria. Eukaryotic cells include but are notlimited to yeast cells and cells derived from plants and animals, forexample mammalian, insect (e.g., Spodoptera) and human cells. Cells maybe useful when they are naturally nonadherent or have been treated notto adhere to surfaces, for example by trypsinization.

The terms “polypeptide,” “peptide” and “protein” are usedinterchangeably herein to refer to a polymer of amino acid residues,wherein the polymer may optionally be conjugated to a moiety that doesnot consist of amino acids. The terms apply to amino acid polymers inwhich one or more amino acid residue is an artificial chemical mimeticof a corresponding naturally occurring amino acid, as well as tonaturally occurring amino acid polymers and non-naturally occurringamino acid polymers. A “fusion protein” refers to a chimeric proteinencoding two or more separate protein sequences that are recombinantlyexpressed as a single moiety.

The term “peptidyl” and “peptidyl moiety” refers to a monovalentpeptide.

A “label” or a “detectable moiety” is a composition detectable byspectroscopic, photochemical, biochemical, immunochemical, chemical, orother physical means. For example, useful labels include ³²P,fluorescent dyes, electron-dense reagents, enzymes (e.g., as commonlyused in an ELISA), biotin, digoxigenin, or haptens and proteins or otherentities which can be made detectable, e.g., by incorporating aradiolabel into a peptide or antibody specifically reactive with atarget peptide. Any appropriate method known in the art for conjugatingan antibody to the label may be employed, e.g., using methods describedin Hermanson, Bioconjugate Techniques 1996, Academic Press, Inc., SanDiego.

A “labeled protein or polypeptide” is one that is bound, eithercovalently, through a linker or a chemical bond, or noncovalently,through ionic, van der Waals, electrostatic, or hydrogen bonds to alabel such that the presence of the labeled protein or polypeptide maybe detected by detecting the presence of the label bound to the labeledprotein or polypeptide. Alternatively, methods using high affinityinteractions may achieve the same results where one of a pair of bindingpartners binds to the other, e.g., biotin, streptavidin.

The term “amino acid” refers to naturally occurring and synthetic aminoacids, as well as amino acid analogs and amino acid mimetics thatfunction in a manner similar to the naturally occurring amino acids.Naturally occurring amino acids are those encoded by the genetic code,as well as those amino acids that are later modified, e.g.,hydroxyproline, γ-carboxyglutamate, and O-phosphoserine. Amino acidanalogs refers to compounds that have the same basic chemical structureas a naturally occurring amino acid, i.e., an a carbon that is bound toa hydrogen, a carboxyl group, an amino group, and an R group, e.g.,homoserine, norleucine, methionine sulfoxide, methionine methylsulfonium. Such analogs have modified R groups (e.g., norleucine) ormodified peptide backbones, but retain the same basic chemical structureas a naturally occurring amino acid. Amino acid mimetics refers tochemical compounds that have a structure that is different from thegeneral chemical structure of an amino acid, but that function in amanner similar to a naturally occurring amino acid.

Amino acids may be referred to herein by either their commonly knownthree letter symbols or by the one-letter symbols recommended by theIUPAC-IUB Biochemical Nomenclature Commission. Nucleotides, likewise,may be referred to by their commonly accepted single-letter codes.

An amino acid modification refers to an amino acid substitution,insertion, and/or deletion in a protein or peptide sequence. An “aminoacid substitution” or “substitution” refers to replacement of an aminoacid at a particular position in a parent peptide or protein sequencewith another amino acid. A substitution can be made to change an aminoacid in the resulting protein in a non-conservative manner (i.e., bychanging the codon from an amino acid belonging to a grouping of aminoacids having a particular size or characteristic to an amino acidbelonging to another grouping) or in a conservative manner (i.e., bychanging the codon from an amino acid belonging to a grouping of aminoacids having a particular size or characteristic to an amino acidbelonging to the same grouping). Such a conservative change generallyleads to less change in the structure and function of the resultingprotein. The following are examples of various groupings of aminoacids: 1) Amino acids with nonpolar R groups: Alanine, Valine, Leucine,Isoleucine, Proline, Phenylalanine, Tryptophan, Methionine; 2) Aminoacids with uncharged polar R groups: Glycine, Serine, Threonine,Cysteine, Tyrosine, Asparagine, Glutamine; 3) Amino acids with chargedpolar R groups (negatively charged at pH 6.0): Aspartic acid, Glutamicacid; 4) Basic amino acids (positively charged at pH 6.0): Lysine,Arginine, Histidine (at pH 6.0). Another grouping may be those aminoacids with phenyl groups: Phenylalanine, Tryptophan, and Tyrosine.

An amino acid or nucleotide base “position” is denoted by a number thatsequentially identifies each amino acid (or nucleotide base) in thereference sequence based on its position relative to the N-terminus (or5′-end). Due to deletions, insertions, truncations, fusions, and thelike that may be taken into account when determining an optimalalignment, in general the amino acid residue number in a test sequencedetermined by simply counting from the N-terminus will not necessarilybe the same as the number of its corresponding position in the referencesequence. For example, in a case where a variant has a deletion relativeto an aligned reference sequence, there will be no amino acid in thevariant that corresponds to a position in the reference sequence at thesite of deletion. Where there is an insertion in an aligned referencesequence, that insertion will not correspond to a numbered amino acidposition in the reference sequence. In the case of truncations orfusions there can be stretches of amino acids in either the reference oraligned sequence that do not correspond to any amino acid in thecorresponding sequence.

The terms “numbered with reference to” or “corresponding to,” when usedin the context of the numbering of a given amino acid or polynucleotidesequence, refers to the numbering of the residues of a specifiedreference sequence when the given amino acid or polynucleotide sequenceis compared to the reference sequence. An amino acid residue in aprotein “corresponds” to a given residue when it occupies the sameessential structural position within the protein as the given residue.For example, a selected residue in a selected antibody (or Fab domain)corresponds to light chain threonine at Kabat position 40, when theselected residue occupies the same essential spatial or other structuralrelationship as a light chain threonine at Kabat position 40. In someembodiments, where a selected protein is aligned for maximum homologywith the light chain of an antibody (or Fab domain), the position in thealigned selected protein aligning with threonine 40 is said tocorrespond to threonine 40. Instead of a primary sequence alignment, athree dimensional structural alignment can also be used, e.g., where thestructure of the selected protein is aligned for maximum correspondencewith the light chain threonine at Kabat position 40, and the overallstructures compared. In this case, an amino acid that occupies the sameessential position as threonine 40 in the structural model is said tocorrespond to the threonine 40 residue.

“Conservatively modified variants” applies to both amino acid andnucleic acid sequences. With respect to particular nucleic acidsequences, conservatively modified variants refers to those nucleicacids which encode identical or essentially identical amino acidsequences, or where the nucleic acid does not encode an amino acidsequence, to essentially identical sequences. Because of the degeneracyof the genetic code, a large number of functionally identical nucleicacids sequences encode any given amino acid residue. For instance, thecodons GCA, GCC, GCG and GCU all encode the amino acid alanine. Thus, atevery position where an alanine is specified by a codon, the codon canbe altered to any of the corresponding codons described without alteringthe encoded polypeptide. Such nucleic acid variations are “silentvariations,” which are one species of conservatively modifiedvariations. Every nucleic acid sequence herein which encodes apolypeptide also describes every possible silent variation of thenucleic acid. One of skill will recognize that each codon in a nucleicacid (except AUG, which is ordinarily the only codon for methionine, andTGG, which is ordinarily the only codon for tryptophan) can be modifiedto yield a functionally identical molecule. Accordingly, each silentvariation of a nucleic acid which encodes a polypeptide is implicit ineach described sequence with respect to the expression product, but notwith respect to actual probe sequences.

As to amino acid sequences, one of skill will recognize that individualsubstitutions, deletions or additions to a nucleic acid, peptide,polypeptide, or protein sequence which alters, adds or deletes a singleamino acid or a small percentage of amino acids in the encoded sequenceis a “conservatively modified variant” where the alteration results inthe substitution of an amino acid with a chemically similar amino acid.Conservative substitution tables providing functionally similar aminoacids are well known in the art. Such conservatively modified variantsare in addition to and do not exclude polymorphic variants, interspecieshomologs, and alleles of the invention.

The following eight groups each contain amino acids that areconservative substitutions for one another: 1) Alanine (A), Glycine (G);2) Aspartic acid (D), Glutamic acid (E); 3) Asparagine (N), Glutamine(Q); 4) Arginine (R), Lysine (K); 5) Isoleucine (I), Leucine (L),Methionine (M), Valine (V); 6) Phenylalanine (F), Tyrosine (Y),Tryptophan (W); 7) Serine (S), Threonine (T); and 8) Cysteine (C),Methionine (M) (see, e.g., Creighton, Proteins (1984)).

“Nucleic acid” refers to deoxyribonucleotides or ribonucleotides andpolymers thereof in either single- or double-stranded form, andcomplements thereof. The term “polynucleotide” refers to a linearsequence of nucleotides. The term “nucleotide” typically refers to asingle unit of a polynucleotide, i.e., a monomer. Nucleotides can beribonucleotides, deoxyribonucleotides, or modified versions thereof.Examples of polynucleotides contemplated herein include single anddouble stranded DNA, single and double stranded RNA (including siRNA),and hybrid molecules having mixtures of single and double stranded DNAand RNA. Nucleic acid as used herein also refers to nucleic acids thathave the same basic chemical structure as a naturally occurring nucleicacid. Such analogues have modified sugars and/or modified ringsubstituents, but retain the same basic chemical structure as thenaturally occurring nucleic acid. A nucleic acid mimetic refers tochemical compounds that have a structure that is different the generalchemical structure of a nucleic acid, but that functions in a mannersimilar to a naturally occurring nucleic acid. Examples of suchanalogues include, without limitation, phosphorothiolates,phosphoramidates, methyl phosphonates, chiral-methyl phosphonates,2-O-methyl ribonucleotides, and peptide-nucleic acids (PNAs).

“Percentage of sequence identity” is determined by comparing twooptimally aligned sequences over a comparison window, wherein theportion of the polynucleotide or polypeptide sequence in the comparisonwindow may comprise additions or deletions (i.e., gaps) as compared tothe reference sequence (which does not comprise additions or deletions)for optimal alignment of the two sequences. The percentage is calculatedby determining the number of positions at which the identical nucleicacid base or amino acid residue occurs in both sequences to yield thenumber of matched positions, dividing the number of matched positions bythe total number of positions in the window of comparison andmultiplying the result by 100 to yield the percentage of sequenceidentity.

The terms “identical” or percent “identity,” in the context of two ormore nucleic acids or polypeptide sequences, refer to two or moresequences or subsequences that are the same or have a specifiedpercentage of amino acid residues or nucleotides that are the same(i.e., 60% identity, optionally 65%, 70%, 75%, 80%, 85%, 90%, 95%, 98%,or 99% identity over a specified region, e.g., of the entire polypeptidesequences of the invention or individual domains of the polypeptides ofthe invention), when compared and aligned for maximum correspondenceover a comparison window, or designated region as measured using one ofthe following sequence comparison algorithms or by manual alignment andvisual inspection. Such sequences are then said to be “substantiallyidentical.” This definition also refers to the complement of a testsequence. Optionally, the identity exists over a region that is at leastabout 50 nucleotides in length, or more preferably over a region that is100 to 500 or 1000 or more nucleotides in length. The present inventionincludes polypeptides that are substantially identical to any of SEQ IDNOs:1-35.

For sequence comparison, typically one sequence acts as a referencesequence, to which test sequences are compared. When using a sequencecomparison algorithm, test and reference sequences are entered into acomputer, subsequence coordinates are designated, if necessary, andsequence algorithm program parameters are designated. Default programparameters can be used, or alternative parameters can be designated. Thesequence comparison algorithm then calculates the percent sequenceidentities for the test sequences relative to the reference sequence,based on the program parameters.

A “comparison window”, as used herein, includes reference to a segmentof any one of the number of contiguous positions selected from the groupconsisting of, e.g., a full length sequence or from 20 to 600, about 50to about 200, or about 100 to about 150 amino acids or nucleotides inwhich a sequence may be compared to a reference sequence of the samenumber of contiguous positions after the two sequences are optimallyaligned. Methods of alignment of sequences for comparison are well knownin the art. Optimal alignment of sequences for comparison can beconducted, e.g., by the local homology algorithm of Smith and Waterman(1970) Adv. Appl. Math. 2:482c, by the homology alignment algorithm ofNeedleman and Wunsch (1970) J. Mol. Biol. 48:443, by the search forsimilarity method of Pearson and Lipman (1988) Proc. Nat'l. Acad. Sci.USA 85:2444, by computerized implementations of these algorithms (GAP,BESTFIT, FASTA, and TFASTA in the Wisconsin Genetics Software Package,Genetics Computer Group, 575 Science Dr., Madison, Wis.), or by manualalignment and visual inspection (see, e.g., Ausubel et al., CurrentProtocols in Molecular Biology (1995 supplement)).

An example of an algorithm that is suitable for determining percentsequence identity and sequence similarity are the BLAST and BLAST 2.0algorithms, which are described in Altschul et al. (1977) Nuc. AcidsRes. 25:3389-3402, and Altschul et al. (1990) J. Mol. Biol. 215:403-410,respectively. Software for performing BLAST analyses is publiclyavailable through the National Center for Biotechnology Information(http://www.ncbi.nlm.nih.gov/). This algorithm involves firstidentifying high scoring sequence pairs (HSPs) by identifying shortwords of length W in the query sequence, which either match or satisfysome positive-valued threshold score T when aligned with a word of thesame length in a database sequence. T is referred to as the neighborhoodword score threshold (Altschul et al., supra). These initialneighborhood word hits act as seeds for initiating searches to findlonger HSPs containing them. The word hits are extended in bothdirections along each sequence for as far as the cumulative alignmentscore can be increased. Cumulative scores are calculated using, fornucleotide sequences, the parameters M (reward score for a pair ofmatching residues; always >0) and N (penalty score for mismatchingresidues; always <0). For amino acid sequences, a scoring matrix is usedto calculate the cumulative score. Extension of the word hits in eachdirection are halted when: the cumulative alignment score falls off bythe quantity X from its maximum achieved value; the cumulative scoregoes to zero or below, due to the accumulation of one or morenegative-scoring residue alignments; or the end of either sequence isreached. The BLAST algorithm parameters W, T, and X determine thesensitivity and speed of the alignment. The BLASTN program (fornucleotide sequences) uses as defaults a wordlength (W) of 11, anexpectation (E) or 10, M=5, N=−4 and a comparison of both strands. Foramino acid sequences, the BLASTP program uses as defaults a wordlengthof 3, and expectation (E) of 10, and the BLOSUM62 scoring matrix (seeHenikoff and Henikoff (1989) Proc. Natl. Acad. Sci. USA 89:10915)alignments (B) of 50, expectation (E) of 10, M=5, N=−4, and a comparisonof both strands.

The BLAST algorithm also performs a statistical analysis of thesimilarity between two sequences (see, e.g., Karlin and Altschul (1993)Proc. Natl. Acad. Sci. USA 90:5873-5787). One measure of similarityprovided by the BLAST algorithm is the smallest sum probability (P(N)),which provides an indication of the probability by which a match betweentwo nucleotide or amino acid sequences would occur by chance. Forexample, a nucleic acid is considered similar to a reference sequence ifthe smallest sum probability in a comparison of the test nucleic acid tothe reference nucleic acid is less than about 0.2, more preferably lessthan about 0.01, and most preferably less than about 0.001.

An indication that two nucleic acid sequences or polypeptides aresubstantially identical is that the polypeptide encoded by the firstnucleic acid is immunologically cross-reactive with the antibodiesraised against the polypeptide encoded by the second nucleic acid, asdescribed below. Thus, a polypeptide is typically substantiallyidentical to a second polypeptide, for example, where the two peptidesdiffer only by conservative substitutions. Another indication that twonucleic acid sequences are substantially identical is that the twomolecules or their complements hybridize to each other under stringentconditions, as described below. Yet another indication that two nucleicacid sequences are substantially identical is that the same primers canbe used to amplify the sequence.

The word “expression” or “expressed” as used herein in reference to agene means the transcriptional and/or translational product of thatgene. The level of expression of a DNA molecule in a cell may bedetermined on the basis of either the amount of corresponding mRNA thatis present within the cell or the amount of protein encoded by that DNAproduced by the cell. The level of expression of non-coding nucleic acidmolecules (e.g., siRNA) may be detected by standard PCR or Northern blotmethods well known in the art. See, Sambrook et al., 1989 MolecularCloning: A Laboratory Manual, 18.1-18.88.

Expression of a transfected gene can occur transiently or stably in acell. During “transient expression” the transfected gene is nottransferred to the daughter cell during cell division. Since itsexpression is restricted to the transfected cell, expression of the geneis lost over time. In contrast, stable expression of a transfected genecan occur when the gene is co-transfected with another gene that confersa selection advantage to the transfected cell. Such a selectionadvantage may be a resistance towards a certain toxin that is presentedto the cell. Expression of a transfected gene can further beaccomplished by transposon-mediated insertion into to the host genome.During transposon-mediated insertion, the gene is positioned in apredictable manner between two transposon linker sequences that allowinsertion into the host genome as well as subsequent excision. Stableexpression of a transfected gene can further be accomplished byinfecting a cell with a lentiviral vector, which after infection formspart of (integrates into) the cellular genome thereby resulting instable expression of the gene.

The terms “plasmid”, “vector” or “expression vector” refer to a nucleicacid molecule that encodes for genes and/or regulatory elementsnecessary for the expression of genes. Expression of a gene from aplasmid can occur in cis or in trans. If a gene is expressed in cis, thegene and the regulatory elements are encoded by the same plasmid.Expression in trans refers to the instance where the gene and theregulatory elements are encoded by separate plasmids.

The terms “transfection”, “transduction”, “transfecting” or“transducing” can be used interchangeably and are defined as a processof introducing a nucleic acid molecule or a protein to a cell. Nucleicacids are introduced to a cell using non-viral or viral-based methods.The nucleic acid molecules may be gene sequences encoding completeproteins or functional portions thereof. Non-viral methods oftransfection include any appropriate transfection method that does notuse viral DNA or viral particles as a delivery system to introduce thenucleic acid molecule into the cell. Exemplary non-viral transfectionmethods include calcium phosphate transfection, liposomal transfection,nucleofection, sonoporation, transfection through heat shock,magnetifection and electroporation. In some embodiments, the nucleicacid molecules are introduced into a cell using electroporationfollowing standard procedures well known in the art. For viral-basedmethods of transfection any useful viral vector may be used in themethods described herein. Examples for viral vectors include, but arenot limited to retroviral, adenoviral, lentiviral and adeno-associatedviral vectors. In some embodiments, the nucleic acid molecules areintroduced into a cell using a retroviral vector following standardprocedures well known in the art. The terms “transfection” or“transduction” also refer to introducing proteins into a cell from theexternal environment. Typically, transduction or transfection of aprotein relies on attachment of a peptide or protein capable of crossingthe cell membrane to the protein of interest. See, e.g., Ford et al.(2001) Gene Therapy 8:1-4 and Prochiantz (2007) Nat. Methods 4:119-20.

“Antibody” refers to a polypeptide comprising a framework region from animmunoglobulin gene or fragments thereof that specifically binds andrecognizes an antigen. The recognized immunoglobulin genes include thekappa, lambda, alpha, gamma, delta, epsilon, and mu constant regiongenes, as well as the myriad immunoglobulin variable region genes. Lightchains are classified as either kappa or lambda. Heavy chains areclassified as gamma, mu, alpha, delta, or epsilon, which in turn definethe immunoglobulin classes, IgG, IgM, IgA, IgD and IgE, respectively.Typically, the antigen-binding region of an antibody plays a significantrole in determining the specificity and affinity of binding. In someembodiments, antibodies or fragments of antibodies may be derived fromdifferent organisms, including humans, mice, rats, hamsters, camels,etc. Antibodies of the invention may include antibodies that have beenmodified or mutated at one or more amino acid positions to improve ormodulate a desired function of the antibody (e.g. glycosylation,expression, antigen recognition, effector functions, antigen binding,specificity, etc.).

Antibodies are large, complex molecules (molecular weight of ˜150,000 orabout 1320 amino acids) with intricate internal structure. A naturalantibody molecule contains two identical pairs of polypeptide chains,each pair having one light chain and one heavy chain. Each light chainand heavy chain in turn consists of two regions: a variable (“V”) regioninvolved in binding the target antigen, and a constant (“C”) region thatinteracts with other components of the immune system. The light andheavy chain variable regions come together in 3-dimensional space toform a variable region that binds the antigen (for example, a receptoron the surface of a cell). Within each light or heavy chain variableregion, there are three short segments (averaging 10 amino acids inlength) called the complementarity determining regions (“CDRs”). The sixCDRs in an antibody variable domain (three from the light chain andthree from the heavy chain) fold up together in 3-dimensional space toform the actual antibody binding site which docks onto the targetantigen. The position and length of the CDRs have been precisely definedby Kabat, E. et al., Sequences of Proteins of Immunological Interest,U.S. Department of Health and Human Services, 1983, 1987. The part of avariable region not contained in the CDRs is called the framework(“FR”), which forms the environment for the CDRs.

An exemplary immunoglobulin (antibody) structural unit comprises atetramer. Each tetramer is composed of two identical pairs ofpolypeptide chains, each pair having one “light” (about 25 kD) and one“heavy” chain (about 50-70 kD). The N-terminus of each chain defines avariable region of about 100 to 110 or more amino acids primarilyresponsible for antigen recognition. The terms variable light chain (VL)or light chain variable region and variable heavy chain (VH) or heavychain variable region refer to these light and heavy chain regions,respectively. The terms variable light chain (VL) and light chainvariable region as referred to herein may be used interchangeably. Theterms variable heavy chain (VH) and heavy chain variable region asreferred to herein may be used interchangeably. The Fc (i.e. fragmentcrystallizable region) is the “base” or “tail” of an immunoglobulin andis typically composed of two heavy chains that contribute two or threeconstant domains depending on the class of the antibody. By binding tospecific proteins the Fc region ensures that each antibody generates anappropriate immune response for a given antigen. The Fc region alsobinds to various cell receptors, such as Fc receptors, and other immunemolecules, such as complement proteins.

The term “antigen” as provided herein refers to molecules capable ofbinding to the antibody region provided herein, wherein the binding siteis not the peptide binding site.

Antibodies exist, for example, as intact immunoglobulins or as a numberof well-characterized fragments produced by digestion with variouspeptidases. Thus, for example, pepsin digests an antibody below thedisulfide linkages in the hinge region to produce F(ab)′2, a dimer ofFab which itself is a light chain joined to VH-CH1 by a disulfide bond.The F(ab)′2 may be reduced under mild conditions to break the disulfidelinkage in the hinge region, thereby converting the F(ab)′2 dimer intoan Fab′ monomer. The Fab′ monomer is essentially the antigen bindingportion with part of the hinge region (see Fundamental Immunology (Pauled., 3d ed. 1993). While various antibody fragments are defined in termsof the digestion of an intact antibody, one of skill will appreciatethat such fragments may be synthesized de novo either chemically or byusing recombinant DNA methodology. Thus, the term antibody, as usedherein, also includes antibody fragments either produced by themodification of whole antibodies, or those synthesized de novo usingrecombinant DNA methodologies (e.g., single chain Fv) or thoseidentified using phage display libraries (see, e.g., McCafferty et al.,Nature 348:552-554 (1990)).

A single-chain variable fragment (scFv) is typically a fusion protein ofthe variable regions of the heavy (VH) and light chains (VL) ofimmunoglobulins, connected with a short linker peptide of 10 to about 25amino acids. The linker may usually be rich in glycine for flexibility,as well as serine or threonine for solubility. The linker can eitherconnect the N-terminus of the VH with the C-terminus of the VL, or viceversa.

The epitope of a mAb is the region of its antigen to which the mAbbinds. Two antibodies bind to the same or overlapping epitope if eachcompetitively inhibits (blocks) binding of the other to the antigen.That is, a 1×, 5×, 10×, 20× or 100× excess of one antibody inhibitsbinding of the other by at least 30% but preferably 50%, 75%, 90% oreven 99% as measured in a competitive binding assay (see, e.g., Junghanset al., Cancer Res. 50:1495, 1990). Alternatively, two antibodies havethe same epitope if essentially all amino acid mutations in the antigenthat reduce or eliminate binding of one antibody reduce or eliminatebinding of the other. Two antibodies have overlapping epitopes if someamino acid mutations that reduce or eliminate binding of one antibodyreduce or eliminate binding of the other.

For preparation of suitable antibodies of the invention and for useaccording to the invention, e.g., recombinant, monoclonal, or polyclonalantibodies, many techniques known in the art can be used (see, e.g.,Kohler & Milstein, Nature 256:495-497 (1975); Kozbor et al., ImmunologyToday 4: 72 (1983); Cole et al., pp. 77-96 in Monoclonal Antibodies andCancer Therapy, Alan R. Liss, Inc. (1985); Coligan, Current Protocols inImmunology (1991); Harlow & Lane, Antibodies, A Laboratory Manual(1988); and Goding, Monoclonal Antibodies: Principles and Practice (2ded. 1986)). The genes encoding the heavy and light chains of an antibodyof interest can be cloned from a cell, e.g., the genes encoding amonoclonal antibody can be cloned from a hybridoma and used to produce arecombinant monoclonal antibody. Gene libraries encoding heavy and lightchains of monoclonal antibodies can also be made from hybridoma orplasma cells. Random combinations of the heavy and light chain geneproducts generate a large pool of antibodies with different antigenicspecificity (see, e.g., Kuby, Immunology (3rd ed. 1997)). Techniques forthe production of single chain antibodies or recombinant antibodies(U.S. Pat. Nos. 4,946,778, 4,816,567) can be adapted to produceantibodies to polypeptides of this invention. Also, transgenic mice, orother organisms such as other mammals, may be used to express humanizedor human antibodies (see, e.g., U.S. Pat. Nos. 5,545,807; 5,545,806;5,569,825; 5,625,126; 5,633,425; 5,661,016, Marks et al., Bio/Technology10:779-783 (1992); Lonberg et al., Nature 368:856-859 (1994); Morrison,Nature 368:812-13 (1994); Fishwild et al., Nature Biotechnology14:845-51 (1996); Neuberger, Nature Biotechnology 14:826 (1996); andLonberg & Huszar, Intern. Rev. Immunol. 13:65-93 (1995)). Alternatively,phage display technology can be used to identify antibodies andheteromeric Fab fragments that specifically bind to selected antigens(see, e.g., McCafferty et al., Nature 348:552-554 (1990); Marks et al.,Biotechnology 10:779-783 (1992)). Antibodies can also be madebispecific, i.e., able to recognize two different antigens (see, e.g.,WO 93/08829, Traunecker et al., EMBO J. 10:3655-3659 (1991); and Sureshet al., Methods in Enzymology 121:210 (1986)). Antibodies can also beheteroconjugates, e.g., two covalently joined antibodies, orimmunotoxins (see, e.g., U.S. Pat. No. 4,676,980, WO 91/00360; WO92/200373; and EP 03089).

Methods for humanizing or primatizing non-human antibodies are wellknown in the art (e.g., U.S. Pat. Nos. 4,816,567; 5,530,101; 5,859,205;5,585,089; 5,693,761; 5,693,762; 5,777,085; 6,180,370; 6,210,671; and6,329,511; WO 87/02671; EP Patent Application 0173494; Jones et al.(1986) Nature 321:522; and Verhoyen et al. (1988) Science 239:1534).Humanized antibodies are further described in, e.g., Winter and Milstein(1991) Nature 349:293. Generally, a humanized antibody has one or moreamino acid residues introduced into it from a source which is non-human.These non-human amino acid residues are often referred to as importresidues, which are typically taken from an import variable domain.Humanization can be essentially performed following the method of Winterand co-workers (see, e.g., Morrison et al., PNAS USA, 81:6851-6855(1984), Jones et al., Nature 321:522-525 (1986); Riechmann et al.,Nature 332:323-327 (1988); Morrison and Oi, Adv. Immunol., 44:65-92(1988), Verhoeyen et al., Science 239:1534-1536 (1988) and Presta, Curr.Op. Struct. Biol. 2:593-596 (1992), Padlan, Molec. Immun., 28:489-498(1991); Padlan, Molec. Immun., 31(3):169-217 (1994)), by substitutingrodent CDRs or CDR sequences for the corresponding sequences of a humanantibody. Accordingly, such humanized antibodies are chimeric antibodies(U.S. Pat. No. 4,816,567), wherein substantially less than an intacthuman variable domain has been substituted by the corresponding sequencefrom a non-human species. In practice, humanized antibodies aretypically human antibodies in which some CDR residues and possibly someFR residues are substituted by residues from analogous sites in rodentantibodies. For example, polynucleotides comprising a first sequencecoding for humanized immunoglobulin framework regions and a secondsequence set coding for the desired immunoglobulin complementaritydetermining regions can be produced synthetically or by combiningappropriate cDNA and genomic DNA segments. Human constant region DNAsequences can be isolated in accordance with well known procedures froma variety of human cells.

A “chimeric antibody” is an antibody molecule in which (a) the constantregion, or a portion thereof, is altered, replaced or exchanged so thatthe antigen binding site (variable region) is linked to a constantregion of a different or altered class, effector function and/orspecies, or an entirely different molecule which confers new propertiesto the chimeric antibody, e.g., an enzyme, toxin, hormone, growthfactor, drug, etc.; or (b) the variable region, or a portion thereof, isaltered, replaced or exchanged with a variable region having a differentor altered antigen specificity. The preferred antibodies of, and for useaccording to the invention include humanized and/or chimeric monoclonalantibodies.

A “therapeutic antibody” as provided herein refers to any antibody orfunctional fragment thereof that is used to treat cancer, autoimmunediseases, transplant rejection, cardiovascular disease or other diseasesor conditions such as those described herein. Non-limiting examples oftherapeutic antibodies include murine antibodies, murinized or humanizedchimera antibodies or human antibodies including, but not limited to,Erbitux (cetuximab), ReoPro (abciximab), Simulect (basiliximab),Remicade (infliximab); Orthoclone OKT3 (muromonab-CD3); Rituxan(rituximab), Bexxar (tositumomab) Humira (adalimumab), Campath(alemtuzumab), Simulect (basiliximab), Avastin (bevacizumab), Cimzia(certolizumab pegol), Zenapax (daclizumab), Soliris (eculizumab),Raptiva (efalizumab), Mylotarg (gemtuzumab), Zevalin (ibritumomabtiuxetan), Tysabri (natalizumab), Xolair (omalizumab), Synagis(palivizumab), Vectibix (panitumumab), Lucentis (ranibizumab), andHerceptin (trastuzumab).

Techniques for conjugating therapeutic agents to antibodies are wellknown (see, e.g., Arnon et al., “Monoclonal Antibodies ForImmunotargeting Of Drugs In Cancer Therapy”, in Monoclonal AntibodiesAnd Cancer Therapy, Reisfeld et al. (eds.), pp. 243-56 (Alan R. Liss,Inc. 1985); Hellstrom et al., “Antibodies For Drug Delivery” inControlled Drug Delivery (2^(nd) Ed.), Robinson et al. (eds.), pp.623-53 (Marcel Dekker, Inc. 1987); Thorpe, “Antibody Carriers OfCytotoxic Agents In Cancer Therapy: A Review” in Monoclonal Antibodies'84: Biological And Clinical Applications, Pinchera et al. (eds.), pp.475-506 (1985); and Thorpe et al., “The Preparation And CytotoxicProperties Of Antibody-Toxin Conjugates”, Immunol. Rev., 62:119-58(1982)). As used herein, the term “antibody-drug conjugate” or “ADC”refers to a therapeutic agent conjugated or otherwise covalently boundto an antibody. A “therapeutic agent” as referred to herein, is acomposition useful in treating or preventing a disease such as cancer.

The phrase “specifically (or selectively) binds” to an antibody or“specifically (or selectively) immunoreactive with,” when referring to aprotein or peptide, refers to a binding reaction that is determinativeof the presence of the protein, often in a heterogeneous population ofproteins and other biologics. Thus, under designated immunoassayconditions, the specified antibodies bind to a particular protein atleast two times the background and more typically more than 10 to 100times background. Specific binding to an antibody under such conditionstypically requires an antibody that is selected for its specificity fora particular protein. For example, polyclonal antibodies can be selectedto obtain only a subset of antibodies that are specificallyimmunoreactive with the selected antigen and not with other proteins.This selection may be achieved by subtracting out antibodies thatcross-react with other molecules. A variety of immunoassay formats maybe used to select antibodies specifically immunoreactive with aparticular protein. For example, solid-phase ELISA immunoassays areroutinely used to select antibodies specifically immunoreactive with aprotein (see, e.g., Harlow & Lane, Using Antibodies, A Laboratory Manual(1998) for a description of immunoassay formats and conditions that canbe used to determine specific immunoreactivity).

protein).

A “ligand” refers to an agent, e.g., a polypeptide or other molecule,capable of binding to a receptor.

The term “recombinant” when used with reference, for example, to a cell,a nucleic acid, a protein, or a vector, indicates that the cell, nucleicacid, protein or vector has been modified by or is the result oflaboratory methods. Thus, for example, recombinant proteins includeproteins produced by laboratory methods. Recombinant proteins caninclude amino acid residues not found within the native(non-recombinant) form of the protein or can be include amino acidresidues that have been modified, e.g., labeled.

The term “heterologous” when used with reference to portions of anucleic acid indicates that the nucleic acid comprises two or moresubsequences that are not found in the same relationship to each otherin nature. For instance, the nucleic acid is typically recombinantlyproduced, having two or more sequences from unrelated genes arranged tomake a new functional nucleic acid, e.g., a promoter from one source anda coding region from another source. Similarly, a heterologous proteinindicates that the protein comprises two or more subsequences that arenot found in the same relationship to each other in nature (e.g., afusion protein).

The term “isolated”, when applied to a nucleic acid or protein, denotesthat the nucleic acid or protein is essentially free of other cellularcomponents with which it is associated in the natural state. It can be,for example, in a homogeneous state and may be in either a dry oraqueous solution.

Purity and homogeneity are typically determined using analyticalchemistry techniques such as polyacrylamide gel electrophoresis or highperformance liquid chromatography. A protein that is the predominantspecies present in a preparation is substantially purified.

“Contacting” is used in accordance with its plain ordinary meaning andrefers to the process of allowing at least two distinct species (e.g.chemical compounds including biomolecules or cells) to becomesufficiently proximal to react, interact or physically touch. It shouldbe appreciated; however, the resulting reaction product can be produceddirectly from a reaction between the added reagents or from anintermediate from one or more of the added reagents which can beproduced in the reaction mixture.

The term “contacting” may include allowing two species to react,interact, or physically touch, wherein the two species may be, forexample, an antigen binding domain as described herein and a compoundprovided herein (e.g., a compound including a peptidyl moiety,meditope). In embodiments contacting includes, for example, allowing acompound described herein to interact with a steric hindering chemicalmolecule.

A “control” sample or value refers to a sample that serves as areference, usually a known reference, for comparison to a test sample.For example, a test sample can be taken from a test condition, e.g., inthe presence of a test compound, and compared to samples from knownconditions, e.g., in the absence of the test compound (negativecontrol), or in the presence of a known compound (positive control). Acontrol can also represent an average value gathered from a number oftests or results. One of skill in the art will recognize that controlscan be designed for assessment of any number of parameters. For example,a control can be devised to compare therapeutic benefit based onpharmacological data (e.g., half-life) or therapeutic measures (e.g.,comparison of side effects). One of skill in the art will understandwhich controls are valuable in a given situation and be able to analyzedata based on comparisons to control values. Controls are also valuablefor determining the significance of data. For example, if values for agiven parameter are widely variant in controls, variation in testsamples will not be considered as significant.

“Patient” or “subject in need thereof” refers to a living organismsuffering from or prone to a disease or condition that can be treated byadministration of a composition or pharmaceutical composition asprovided herein. Non-limiting examples include humans, other mammals,bovines, rats, mice, dogs, monkeys, goat, sheep, cows, deer, and othernon-mammalian animals. In some embodiments, a patient is human.

The terms “disease” or “condition” refer to a state of being or healthstatus of a patient or subject capable of being treated with a compound,pharmaceutical composition, or method provided herein. In embodiments,the disease is cancer (e.g. lung cancer, ovarian cancer, osteosarcoma,bladder cancer, cervical cancer, liver cancer, kidney cancer, skincancer (e.g., Merkel cell carcinoma), testicular cancer, leukemia,lymphoma, head and neck cancer, colorectal cancer, prostate cancer,pancreatic cancer, melanoma, breast cancer, neuroblastoma).

The terms “treating”, or “treatment” refers to any indicia of success inthe treatment or amelioration of an injury, disease, pathology orcondition, including any objective or subjective parameter such asabatement; remission; diminishing of symptoms or making the injury,pathology or condition more tolerable to the patient; slowing in therate of degeneration or decline; making the final point of degenerationless debilitating; improving a patient's physical or mental well-being.The treatment or amelioration of symptoms can be based on objective orsubjective parameters; including the results of a physical examination,neuropsychiatric exams, and/or a psychiatric evaluation. The term“treating” and conjugations thereof, include prevention of an injury,pathology, condition, or disease. In embodiments, “treating” refers totreatment of cancer.

An “effective amount” is an amount sufficient for a compound toaccomplish a stated purpose relative to the absence of the compound(e.g. achieve the effect for which it is administered, treat a disease,reduce enzyme activity, increase enzyme activity, reduce a signalingpathway, or reduce one or more symptoms of a disease or condition). Anexample of an “therapeutically effective amount” is an amount sufficientto contribute to the treatment, prevention, or reduction of a symptom orsymptoms of a disease, which could also be referred to as a“therapeutically effective amount.” A “reduction” of a symptom orsymptoms (and grammatical equivalents of this phrase) means decreasingof the severity or frequency of the symptom(s), or elimination of thesymptom(s). The exact amounts will depend on the purpose of thetreatment, and will be ascertainable by one skilled in the art usingknown techniques (see, e.g., Lieberman, Pharmaceutical Dosage Forms(vols. 1-3, 1992); Lloyd, The Art, Science and Technology ofPharmaceutical Compounding (1999); Pickar, Dosage Calculations (1999);and Remington: The Science and Practice of Pharmacy, 20th Edition, 2003,Gennaro, Ed., Lippincott, Williams & Wilkins).

As used herein, the term “cancer” refers to all types of cancer,neoplasm or malignant tumors found in mammals, including leukemias,lymphomas, melanomas, neuroendocrine tumors, carcinomas and sarcomas.Exemplary cancers that may be treated with a compound, pharmaceuticalcomposition, or method provided herein include lymphoma, sarcoma,bladder cancer, bone cancer, brain tumor, cervical cancer, colon cancer,esophageal cancer, gastric cancer, head and neck cancer, kidney cancer,myeloma, thyroid cancer, leukemia, prostate cancer, breast cancer (e.g.triple negative, ER positive, ER negative, chemotherapy resistant,herceptin resistant, HER2 positive, doxorubicin resistant, tamoxifenresistant, ductal carcinoma, lobular carcinoma, primary, metastatic),ovarian cancer, pancreatic cancer, liver cancer (e.g., hepatocellularcarcinoma), lung cancer (e.g. non-small cell lung carcinoma, squamouscell lung carcinoma, adenocarcinoma, large cell lung carcinoma, smallcell lung carcinoma, carcinoid, sarcoma), glioblastoma multiforme,glioma, melanoma, prostate cancer, castration-resistant prostate cancer,breast cancer, triple negative breast cancer, glioblastoma, ovariancancer, lung cancer, squamous cell carcinoma (e.g., head, neck, oresophagus), colorectal cancer, leukemia, acute myeloid leukemia,lymphoma, B cell lymphoma, or multiple myeloma. Additional examplesinclude, cancer of the thyroid, endocrine system, brain, breast, cervix,colon, head & neck, esophagus, liver, kidney, lung, non-small cell lung,melanoma, mesothelioma, ovary, sarcoma, stomach, uterus orMedulloblastoma, Hodgkin's Disease, Non-Hodgkin's Lymphoma, multiplemyeloma, neuroblastoma, glioma, glioblastoma multiforme, ovarian cancer,rhabdomyosarcoma, primary thrombocytosis, primary macroglobulinemia,primary brain tumors, cancer, malignant pancreatic insulanoma, malignantcarcinoid, urinary bladder cancer, premalignant skin lesions, testicularcancer, lymphomas, thyroid cancer, neuroblastoma, esophageal cancer,genitourinary tract cancer, malignant hypercalcemia, endometrial cancer,adrenal cortical cancer, neoplasms of the endocrine or exocrinepancreas, medullary thyroid cancer, medullary thyroid carcinoma,melanoma, colorectal cancer, papillary thyroid cancer, hepatocellularcarcinoma, Paget's Disease of the Nipple, Phyllodes Tumors, LobularCarcinoma, Ductal Carcinoma, cancer of the pancreatic stellate cells,cancer of the hepatic stellate cells, or prostate cancer.

The term “leukemia” refers broadly to progressive, malignant diseases ofthe blood-forming organs and is generally characterized by a distortedproliferation and development of leukocytes and their precursors in theblood and bone marrow. Leukemia is generally clinically classified onthe basis of (1) the duration and character of the disease-acute orchronic; (2) the type of cell involved; myeloid (myelogenous), lymphoid(lymphogenous), or monocytic; and (3) the increase or non-increase inthe number abnormal cells in the blood-leukemic or aleukemic(subleukemic). Exemplary leukemias that may be treated with a compound,pharmaceutical composition, or method provided herein include, forexample, acute nonlymphocytic leukemia, chronic lymphocytic leukemia,acute granulocytic leukemia, chronic granulocytic leukemia, acutepromyelocytic leukemia, adult T-cell leukemia, aleukemic leukemia, aleukocythemic leukemia, basophylic leukemia, blast cell leukemia, bovineleukemia, chronic myelocytic leukemia, leukemia cutis, embryonalleukemia, eosinophilic leukemia, Gross' leukemia, hairy-cell leukemia,hemoblastic leukemia, hemocytoblastic leukemia, histiocytic leukemia,stem cell leukemia, acute monocytic leukemia, leukopenic leukemia,lymphatic leukemia, lymphoblastic leukemia, lymphocytic leukemia,lymphogenous leukemia, lymphoid leukemia, lymphosarcoma cell leukemia,mast cell leukemia, megakaryocytic leukemia, micromyeloblastic leukemia,monocytic leukemia, myeloblastic leukemia, myelocytic leukemia, myeloidgranulocytic leukemia, myelomonocytic leukemia, Naegeli leukemia, plasmacell leukemia, multiple myeloma, plasmacytic leukemia, promyelocyticleukemia, Rieder cell leukemia, Schilling's leukemia, stem cellleukemia, subleukemic leukemia, or undifferentiated cell leukemia.

The term “sarcoma” generally refers to a tumor which is made up of asubstance like the embryonic connective tissue and is generally composedof closely packed cells embedded in a fibrillar or homogeneoussubstance. Sarcomas that may be treated with a compound, pharmaceuticalcomposition, or method provided herein include a chondrosarcoma,fibrosarcoma, lymphosarcoma, melanosarcoma, myxosarcoma, osteosarcoma,Abernethy's sarcoma, adipose sarcoma, liposarcoma, alveolar soft partsarcoma, ameloblastic sarcoma, botryoid sarcoma, chloroma sarcoma,chorio carcinoma, embryonal sarcoma, Wilms' tumor sarcoma, endometrialsarcoma, stromal sarcoma, Ewing's sarcoma, fascial sarcoma, fibroblasticsarcoma, giant cell sarcoma, granulocytic sarcoma, Hodgkin's sarcoma,idiopathic multiple pigmented hemorrhagic sarcoma, immunoblastic sarcomaof B cells, lymphoma, immunoblastic sarcoma of T-cells, Jensen'ssarcoma, Kaposi's sarcoma, Kupffer cell sarcoma, angiosarcoma,leukosarcoma, malignant mesenchymoma sarcoma, parosteal sarcoma,reticulocytic sarcoma, Rous sarcoma, serocystic sarcoma, synovialsarcoma, or telangiectaltic sarcoma.

The term “melanoma” is taken to mean a tumor arising from themelanocytic system of the skin and other organs. Melanomas that may betreated with a compound, pharmaceutical composition, or method providedherein include, for example, acral-lentiginous melanoma, amelanoticmelanoma, benign juvenile melanoma, Cloudman's melanoma, S91 melanoma,Harding-Passey melanoma, juvenile melanoma, lentigo maligna melanoma,malignant melanoma, nodular melanoma, subungal melanoma, or superficialspreading melanoma.

The term “carcinoma” refers to a malignant new growth made up ofepithelial cells tending to infiltrate the surrounding tissues and giverise to metastases. Exemplary carcinomas that may be treated with acompound, pharmaceutical composition, or method provided herein include,for example, medullary thyroid carcinoma, familial medullary thyroidcarcinoma, acinar carcinoma, acinous carcinoma, adenocystic carcinoma,adenoid cystic carcinoma, carcinoma adenomatosum, carcinoma of adrenalcortex, alveolar carcinoma, alveolar cell carcinoma, basal cellcarcinoma, carcinoma basocellulare, basaloid carcinoma, basosquamouscell carcinoma, bronchioalveolar carcinoma, bronchiolar carcinoma,bronchogenic carcinoma, cerebriform carcinoma, cholangiocellularcarcinoma, chorionic carcinoma, colloid carcinoma, comedo carcinoma,corpus carcinoma, cribriform carcinoma, carcinoma en cuirasse, carcinomacutaneum, cylindrical carcinoma, cylindrical cell carcinoma, ductcarcinoma, ductal carcinoma, carcinoma durum, embryonal carcinoma,encephaloid carcinoma, epiermoid carcinoma, carcinoma epithelialeadenoides, exophytic carcinoma, carcinoma ex ulcere, carcinoma fibrosum,gelatiniforni carcinoma, gelatinous carcinoma, giant cell carcinoma,carcinoma gigantocellulare, glandular carcinoma, granulosa cellcarcinoma, hair-matrix carcinoma, hematoid carcinoma, hepatocellularcarcinoma, Hurthle cell carcinoma, hyaline carcinoma, hypernephroidcarcinoma, infantile embryonal carcinoma, carcinoma in situ,intraepidermal carcinoma, intraepithelial carcinoma, Krompecher'scarcinoma, Kulchitzky-cell carcinoma, large-cell carcinoma, lenticularcarcinoma, carcinoma lenticulare, lipomatous carcinoma, lobularcarcinoma, lymphoepithelial carcinoma, carcinoma medullare, medullarycarcinoma, melanotic carcinoma, carcinoma molle, mucinous carcinoma,carcinoma muciparum, carcinoma mucocellulare, mucoepidermoid carcinoma,carcinoma mucosum, mucous carcinoma, carcinoma myxomatodes,nasopharyngeal carcinoma, oat cell carcinoma, carcinoma ossificans,osteoid carcinoma, papillary carcinoma, periportal carcinoma,preinvasive carcinoma, prickle cell carcinoma, pultaceous carcinoma,renal cell carcinoma of kidney, reserve cell carcinoma, carcinomasarcomatodes, schneiderian carcinoma, scirrhous carcinoma, carcinomascroti, signet-ring cell carcinoma, carcinoma simplex, small-cellcarcinoma, solanoid carcinoma, spheroidal cell carcinoma, spindle cellcarcinoma, carcinoma spongiosum, squamous carcinoma, squamous cellcarcinoma, string carcinoma, carcinoma telangiectaticum, carcinomatelangiectodes, transitional cell carcinoma, carcinoma tuberosum,tubular carcinoma, tuberous carcinoma, verrucous carcinoma, or carcinomavillosum.

As used herein, the terms “metastasis,” “metastatic,” and “metastaticcancer” can be used interchangeably and refer to the spread of aproliferative disease or disorder, e.g., cancer, from one organ oranother non-adjacent organ or body part. Cancer occurs at an originatingsite, e.g., breast, which site is referred to as a primary tumor, e.g.,primary breast cancer. Some cancer cells in the primary tumor ororiginating site acquire the ability to penetrate and infiltratesurrounding normal tissue in the local area and/or the ability topenetrate the walls of the lymphatic system or vascular systemcirculating through the system to other sites and tissues in the body. Asecond clinically detectable tumor formed from cancer cells of a primarytumor is referred to as a metastatic or secondary tumor. When cancercells metastasize, the metastatic tumor and its cells are presumed to besimilar to those of the original tumor. Thus, if lung cancermetastasizes to the breast, the secondary tumor at the site of thebreast consists of abnormal lung cells and not abnormal breast cells.The secondary tumor in the breast is referred to a metastatic lungcancer. Thus, the phrase metastatic cancer refers to a disease in whicha subject has or had a primary tumor and has one or more secondarytumors. The phrases non-metastatic cancer or subjects with cancer thatis not metastatic refers to diseases in which subjects have a primarytumor but not one or more secondary tumors. For example, metastatic lungcancer refers to a disease in a subject with or with a history of aprimary lung tumor and with one or more secondary tumors at a secondlocation or multiple locations, e.g., in the breast.

“Anti-cancer agent” is used in accordance with its plain ordinarymeaning and refers to a composition (e.g. compound, drug, antagonist,inhibitor, modulator) having antineoplastic properties or the ability toinhibit the growth or proliferation of cells. In embodiments, ananti-cancer agent is a chemotherapeutic. In embodiments, an anti-canceragent is an agent identified herein having utility in methods oftreating cancer. In embodiments, an anti-cancer agent is an agentapproved by the FDA or similar regulatory agency of a country other thanthe USA, for treating cancer.

The term “associated” or “associated with” in the context of a substanceor substance activity or function associated with a disease (e.g.,diabetes, cancer (e.g. prostate cancer, renal cancer, metastatic cancer,melanoma, castration-resistant prostate cancer, breast cancer, triplenegative breast cancer, glioblastoma, ovarian cancer, lung cancer,squamous cell carcinoma (e.g., head, neck, or esophagus), colorectalcancer, leukemia, acute myeloid leukemia, lymphoma, B cell lymphoma, ormultiple myeloma)) means that the disease (e.g. lung cancer, ovariancancer, osteosarcoma, bladder cancer, cervical cancer, liver cancer,kidney cancer, skin cancer (e.g., Merkel cell carcinoma), testicularcancer, leukemia, lymphoma, head and neck cancer, colorectal cancer,prostate cancer, pancreatic cancer, melanoma, breast cancer,neuroblastoma) is caused by (in whole or in part), or a symptom of thedisease is caused by (in whole or in part) the substance or substanceactivity or function.

“Chemotherapeutic” or “chemotherapeutic agent” is used in accordancewith its plain ordinary meaning and refers to a chemical composition orcompound having antineoplastic properties or the ability to inhibit thegrowth or proliferation of cells.

The term “aberrant” as used herein refers to different from normal. Whenused to describe enzymatic activity, aberrant refers to activity that isgreater or less than a normal control or the average of normalnon-diseased control samples. Aberrant activity may refer to an amountof activity that results in a disease, wherein returning the aberrantactivity to a normal or non-disease-associated amount (e.g. by using amethod as described herein), results in reduction of the disease or oneor more disease symptoms.

DESCRIPTION

The methods and compositions provided herein relate, inter alia, to Tcells expressing (i) a recombinant CAR protein which includes a peptidebinding site and is capable of specifically binding cancer-specificantigens and (ii) a T cell receptor specific for a viral antigen (e.g.,a CMV pp65 protein). The engineered T cells provided herein may be usedin combination with a viral vaccine (e.g. cytomegalovirus (CMV) TriplexVaccine) provided herein to treat a variety of cancers. The methodsprovided herein include administering the engineered T cells whichrecognize a cancer antigen (e.g., CD19, HER2) in addition to a viral(e.g., CMV) antigen to a patient. Subsequent to administration of theengineered T cells, a viral vaccine (e.g., CMV Triplex Vaccine) isadministered to the patient. The vaccine can promote proliferation ofthe engineered T cells and enhance their anti-cancer activity. Thus, themethods can improve T cell resistance and provide a means by which tore-stimulate CAR T cells after relapse. In addition, the methods canprovide more reliable engraftment and persistence in a lowtarget-antigen setting (e.g., post-myeloablative HCT) with re-expansionof CAR T cells by viral (e.g. CMV) vaccine administration. The methodsdescribed herein also permit in vivo expansion of CMV-specific CAR Tcells, instead of or in addition to ex vivo expansion, avoidingexcessive T cell exhaustion that results in some cases from ex vivomanufacturing.

In an aspect is provided a method for treating a disease in a subject inneed thereof, the method including: (i) administering to a subject atherapeutically effective amount of a composition including a populationof human T cells expressing a T cell receptor specific for acytomegalovirus (CMV) antigen and a recombinant chimeric antigenreceptor (CAR) protein, wherein the recombinant CAR protein includes:(A) an antibody region including a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein the central cavity forms a peptide binding site includingframework region amino acid residues; and (B) a transmembrane domain;and (ii) administering to the subject a therapeutically effective amountof a viral vector, wherein the viral vector encodes (a) a CMV pp65protein and (b) a fusion protein including exon 4 of CMV protein IE1(e4) and exon 5 of CMV protein IE2 (e5); and wherein the viral vector isadministered either prior to or subsequent to administering thecomposition including a population of human T cells to the subject,thereby treating the subject.

In embodiments, the antibody region is an antibody fragment. Inembodiments, the antibody region includes an Fc domain. In embodiments,the antibody region is a humanized antibody region.

In embodiments, the recombinant CAR protein further includes anintracellular T-cell signaling domain. In embodiments, the intracellularT-cell signaling domain is a CD3 (intracellular T-cell signaling domain.

In embodiments, the recombinant CAR protein further includes anintracellular co-stimulatory signaling domain. In embodiments, theintracellular co-stimulatory signaling domain is a CD28 intracellularco-stimulatory signaling domain, a 4-1BB intracellular co-stimulatorysignaling domain, an ICOS intracellular co-stimulatory signaling domain,or an OX-40 intracellular co-stimulatory signaling domain. Inembodiments, the intracellular co-stimulatory signaling domain is a CD28intracellular co-stimulatory signaling domain. In embodiments, theintracellular co-stimulatory signaling domain is a 4-1BB intracellularco-stimulatory signaling domain. In embodiments, the intracellularco-stimulatory signaling domain is an ICOS intracellular co-stimulatorysignaling domain. In embodiments, the intracellular co-stimulatorysignaling domain is an OX-40 intracellular co-stimulatory signalingdomain.

In embodiments, the recombinant CAR protein further includes a spacerregion. In embodiments, the spacer region is between the transmembranedomain and the antibody region.

In embodiments, the recombinant CAR protein further includes a linkerdomain. In embodiments, the linker domain is between the transmembranedomain and the intracellular T-cell signaling domain. In embodiments,the linker domain is between the intracellular T-cell signaling domainand the intracellular co-stimulatory signaling domain. In embodiments,the linker domain includes the sequence GGCGG or GGG.

In embodiments, the recombinant CAR protein is an anti-CD19 protein,anti-CD20 protein, anti-CD22 protein, anti-CD30 protein, anti-CD33protein, anti-CD44v6/7/8 protein, anti-CD123 protein, anti-CEA protein,anti-EGP-2 protein, anti-EGP-40 protein, anti-erb-B2 protein,anti-erb-B2,3,4 protein, anti-FBP protein, anti-fetal acetylcholinereceptor protein, anti-GD2 protein, anti-GD3 protein, anti-Her2/neuprotein, anti-IL-13R-a2 protein, anti-KDR protein, anti k-light chainprotein, anti-LeY protein, anti-L1 cell adhesion molecule protein,anti-MAGE-A1 protein, anti-mesothelin protein, anti-murine CMV infectedcell protein, anti-MUC2 protein, anti-NKGD2 protein, anti, oncofetalantigen protein, anti-PCSA protein, anti-PSMA protein, anti-TAA(targeted by mAb IfE) protein, anti-EGFR protein, anti-TAG-72 protein oranti-VEGF-72 protein.

In embodiments, the recombinant CAR protein is an anti-CD19 protein. Inembodiments, the recombinant CAR protein is an anti-CD20 protein. Inembodiments, the recombinant CAR protein is an anti-CD22 protein. Inembodiments, the recombinant CAR protein is an anti-CD30 protein. Inembodiments, the recombinant CAR protein is an anti-CD33 protein. Inembodiments, the recombinant CAR protein is an anti-CD44v6/7/8 protein.In embodiments, the recombinant CAR protein is an anti-CD123 protein. Inembodiments, the recombinant CAR protein is an anti-CEA protein. Inembodiments, the recombinant CAR protein is an anti-EGP-2 protein. Inembodiments, the recombinant CAR protein is an anti-EGP-40 protein. Inembodiments, the recombinant CAR protein is an anti-erb-B2 protein. Inembodiments, the recombinant CAR protein is an anti-erb-B2,3,4 protein.In embodiments, the recombinant CAR protein is an anti-FBP protein. Inembodiments, the recombinant CAR protein is an anti-fetal acetylcholinereceptor protein. In embodiments, the recombinant CAR protein is ananti-GD2 protein. In embodiments, the recombinant CAR protein is ananti-GD3 protein. In embodiments, the recombinant CAR protein is ananti-Her2/neu protein. In embodiments, the recombinant CAR protein is ananti-IL-13R-a2 protein. In embodiments, the recombinant CAR protein isan anti-KDR protein. In embodiments, the recombinant CAR protein is ananti k-light chain protein. In embodiments, the recombinant CAR proteinis an anti-LeY protein. In embodiments, the recombinant CAR protein isan anti-L1 cell adhesion molecule protein. In embodiments, therecombinant CAR protein is an anti-MAGE-A1 protein, anti-mesothelinprotein. In embodiments, the recombinant CAR protein is an anti-murineCMV infected cell protein. In embodiments, the recombinant CAR proteinis an anti-MUC2 protein. In embodiments, the recombinant CAR protein isan anti-NKGD2 protein. In embodiments, the recombinant CAR protein is ananti-oncofetal antigen protein. In embodiments, the recombinant CARprotein is an anti-PCSA protein. In embodiments, the recombinant CARprotein is an anti-PSMA protein. In embodiments, the recombinant CARprotein is an anti-TAA (targeted by mAb IfE) protein. In embodiments,the recombinant CAR protein is an anti-EGFR protein. In embodiments, therecombinant CAR protein is an anti-TAG-72 protein. In embodiments, therecombinant CAR protein is an anti-VEGF-72 protein.

In embodiments, the step of administering a therapeutically effectiveamount of a viral vector to the subject includes administeringrecombinant MVA virus.

In embodiments, expression of (a) a CMV pp65 protein and (b) the fusionprotein including exon 4 of CMV protein IE1 (e4) and exon 5 of CMVprotein IE2 (e5) is under the control of mH5 promoter.

In embodiments, the subject is immunocompromised. In embodiments, thesubject receives immunosuppressive therapy. In embodiments, the subjectis immunocompetent.

In embodiments, the subject is CMV-seronegative prior to treatment.

In embodiments, the subject received hematopoietic stem cells (HSCs)from a CMV-seropositive or a CMV-seronegative donor prior toadministering the therapeutically effective amount of the compositionincluding a population of human T cells expressing a T cell receptorspecific for a CMV antigen and a recombinant CAR protein. Inembodiments, the subject received hematopoietic stem cells (HSCs) from aCMV-seropositive donor prior to administering the therapeuticallyeffective amount of the composition including a population of human Tcells expressing a T cell receptor specific for a CMV antigen and arecombinant CAR protein. In embodiments, the subject receivedhematopoietic stem cells (HSCs) from a CMV-seronegative donor prior toadministering the therapeutically effective amount of the compositionincluding a population of human T cells expressing a T cell receptorspecific for a CMV antigen and a recombinant CAR protein.

In embodiments, the viral vector is administered to the hematopoieticstem cell donor prior to harvesting the stem cells.

In embodiments, the recombinant CAR protein is capable of binding CD19.In embodiments, the recombinant CAR protein is capable of binding HER2.

In embodiments, the HSCs are autologous HSCs. In embodiments, the HSCsare allogenic HSCs.

In embodiments, the subject is suffering from cancer. In embodiments,the subject is suffering from non-Hodgkin's Lymphoma. In embodiments,the subject is suffering from a solid tumor cancer or a hematologicmalignancy. In embodiments, the subject is suffering from a solid tumorcancer. In embodiments, the subject is suffering from a hematologicmalignancy.

In embodiments, the subject is suffering from ovarian cancer, renal cellcarcinoma, a B-cell malignancy, leukemia, lymphoma, breast cancer,colorectal cancer, prostate cancer, neuroblastoma, melanoma,medulloblastoma, lung cancer, osteosarcoma, glioblastoma or glioma. Inembodiments, the subject is suffering from ovarian cancer. Inembodiments, the subject is suffering from renal cell carcinoma. Inembodiments, the subject is suffering from a B-cell malignancy. Inembodiments, the subject is suffering from leukemia. In embodiments, thesubject is suffering from lymphoma. In embodiments, the subject issuffering from breast cancer. In embodiments, the subject is sufferingfrom colorectal cancer. In embodiments, the subject is suffering fromprostate cancer. In embodiments, the subject is suffering fromneuroblastoma. In embodiments, the subject is suffering from melanoma.In embodiments, the subject is suffering from medulloblastoma. Inembodiments, the subject is suffering from lung cancer. In embodiments,the subject is suffering from osteosarcoma. In embodiments, the subjectis suffering from glioblastoma. In embodiments, the subject is sufferingfrom glioma.

In embodiments, administration of the viral vector occurs at least 5days after treatment with the composition including a population ofhuman T cells. In embodiments, the viral vector is administered to thesubject prior to and subsequent to the administration of the compositionincluding a population of human T cells.

In embodiments, the viral vector is administered to the subject onlyprior to the administration of the composition including a population ofhuman T cells. In embodiments, the viral vector is administered to thesubject only subsequent to the administration of the compositionincluding a population of human T cells.

In embodiments, the viral vector is administered to the subject or thehematopoietic stem cell transplant donor at least twice subsequent tothe administration of the composition comprising a population of human Tcells. In embodiments, the viral vector is administered to the subjector the hematopoietic stem cell transplant donor at least three timessubsequent to the administration of the composition comprising apopulation of human T cells. In embodiments, the viral vector isadministered to the subject or the hematopoietic stem cell transplantdonor at least four times subsequent to the administration of thecomposition comprising a population of human T cells. In embodiments,the viral vector is administered to the subject or the hematopoieticstem cell transplant donor at least five times subsequent to theadministration of the composition comprising a population of human Tcells. In embodiments, the viral vector is administered to the subjector the hematopoietic stem cell transplant donor at least six timessubsequent to the administration of the composition comprising apopulation of human T cells. In embodiments, the viral vector isadministered to the subject or the hematopoietic stem cell transplantdonor at least seven times subsequent to the administration of thecomposition comprising a population of human T cells. In embodiments,the viral vector is administered to the subject or the hematopoieticstem cell transplant donor at least eight times subsequent to theadministration of the composition comprising a population of human Tcells. In embodiments, the viral vector is administered to the subjector the hematopoietic stem cell transplant donor at least nine timessubsequent to the administration of the composition comprising apopulation of human T cells. In embodiments, the viral vector isadministered to the subject or the hematopoietic stem cell transplantdonor at least ten times subsequent to the administration of thecomposition comprising a population of human T cells.

In embodiments, the viral vector is administered to the subject at leastfour times. In embodiments, the viral vector is administered to thesubject at least five times. In embodiments, the viral vector isadministered to the subject at least six times. In embodiments, theviral vector is administered to the subject at least seven times. Inembodiments, the viral vector is administered to the subject at leasteight times. In embodiments, the viral vector is administered to thesubject at least nine times. In embodiments, the viral vector isadministered to the subject at least ten times.

In embodiments, the population of human T cells expressing a T cellreceptor specific for a CMV antigen and a recombinant CAR protein isformed by: (1) isolating PBMCs or a T cell subpopulation from aCMV-seropositive human donor; (2) contacting the PBMCs or the T cellsubpopulation with at least one CMV antigen; (3) allowing the contactedcells to produce a population of cells enriched for stimulated cellsspecific for CMV; (4) transducing at least a portion of the enrichedpopulation of cells with a vector expressing a recombinant CAR protein,thereby forming a population of human T cells expressing a T cellreceptor specific for a CMV antigen and a recombinant CAR protein.

In embodiments, the step of allowing the contacted cells to produce apopulation of cells enriched for stimulated cells specific for CMVincludes allowing the stimulated cells to produce a population of cellsenriched for cells expressing an activation marker.

In embodiments, the population of human T cells expressing a T cellreceptor specific for a CMV antigen and a recombinant CAR protein isformed by: (1) administering a viral vector encoding: (a) a CMV pp65protein and (b) a fusion protein including exon 4 of CMV protein IE1(e4) and exon 5 of CMV protein IE2 (e5) to a human donor to convert aCMV-seronegative human donor to a CMV-seropositive human donorcontaining T cells responsive to CMV antigens pp65, IE1 and IE2; (2)obtaining PBMCs from the CMV-seropositive human donor; (3) contactingthe PBMCs with at least one CMV antigen; (4) allowing the contactedcells to produce a population of cells enriched for stimulated cellsspecific for CMV; (5) transducing at least a portion of the enrichedpopulation of cells with a vector expressing a recombinant CAR protein,thereby forming a population of T cell expressing a T cell receptorspecific for a CMV antigen and a recombinant CAR protein.

In embodiments, the population of human T cells expressing a T cellreceptor specific for a CMV antigen and a recombinant CAR protein isformed by: (1) administering a viral vector encoding: (a) a CMV pp65protein and (b) a fusion protein including exon 4 of CMV protein IE1(e4) and exon 5 of CMV protein IE2 (e5) to a CMV-seropositive humandonor; (2) allowing PBMCs from the CMV-seropositive human donor; (3)contacting the PBMCs with at least one CMV antigen; (4) allowing thecontacted cells to produce a population of cells enriched for stimulatedcells specific for CMV; (5) transducing at least a portion of theenriched population of cells with a vector expressing a recombinant CARprotein, thereby providing a population of human T cells expressing a Tcell receptor specific for a CMV antigen and a recombinant CAR protein.

In an aspect is provided a method for forming a population of human Tcells expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen, the method including: (1) administering aviral vector encoding: (a) a CMV pp65 protein and (b) a fusion proteinincluding exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a CMV-seronegative human donor; (2) obtaining PBMCs from thehuman donor; (3) contacting the PBMCs with at least one CMV antigen; (3)allowing the contacted cells to produce a population of cells enrichedfor stimulated cells specific for CMV; (4) transducing at least aportion of the enriched population of cells with a vector expressing arecombinant CAR protein, thereby forming a population of human T cellsexpressing a T cell receptor specific for a CMV antigen and arecombinant CAR protein.

In a aspect is provided a method for forming a population of human Tcells expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen, the method including: (1) administering aviral vector encoding: (a) a CMV pp65 protein and (b) a fusion proteincomprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a CMV-seropositive human donor; (2) obtaining PBMCs from theCMV-seropositive human donor; (3) contacting the PBMCs with at least oneCMV antigen; (4) allowing the contacted cells to produce a population ofcells enriched for stimulated cells specific for CMV; (5) transducing atleast a portion of the enriched population of cells with a vectorexpressing a recombinant CAR protein, thereby forming a population ofhuman T cells expressing a T cell receptor specific for a CMV antigenand a recombinant CAR protein.

In embodiments, the method further includes expanding the population ofhuman T cells expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen.

In embodiments, the activation marker is IFN-γ, CD137 or CD107. Inembodiments, the activation marker is IFN-γ. In embodiments, theactivation marker is CD137. In embodiments, the activation marker isCD107.

In embodiments, the CMV antigen is a pp65 protein or an antigenicportion thereof. In embodiments, the CMV antigen includes two or moredifferent antigenic pp65 proteins. In embodiments, the CMV antigenincludes three or more different antigenic pp65 proteins. Inembodiments, the CMV antigen includes four or more different antigenicpp65 proteins. In embodiments, the CMV antigen includes five or moredifferent antigenic pp65 proteins. In embodiments, the CMV antigenincludes six or more different antigenic pp65 proteins. In embodiments,the CMV antigen includes seven or more different antigenic pp65proteins. In embodiments, the CMV antigen includes eight or moredifferent antigenic pp65 proteins. In embodiments, the CMV antigenincludes nine or more different antigenic pp65 proteins. In embodiments,the CMV antigen includes ten or more different antigenic pp65 proteins.

In embodiments, the enriched population of cells is at least 40% IFN-γpositive, at least 20% CD8 positive, and at least 20% CD4 positive.

In embodiments, the enriched population of cells is cultured for fewerthan 10 days prior to the step of transducing the enriched population ofcells with a vector encoding a recombinant CAR protein. In embodiments,the enriched population of cells is cultured for fewer than 9 days priorto the step of transducing the enriched population of cells with avector encoding a recombinant CAR protein. In embodiments, the enrichedpopulation of cells is cultured for fewer than 8 days prior to the stepof transducing the enriched population of cells with a vector encoding arecombinant CAR protein. In embodiments, the enriched population ofcells is cultured for fewer than 7 days prior to the step of transducingthe enriched population of cells with a vector encoding a recombinantCAR protein. In embodiments, the enriched population of cells iscultured for fewer than 6 days prior to the step of transducing theenriched population of cells with a vector encoding a recombinant CARprotein. In embodiments, the enriched population of cells is culturedfor fewer than 5 days prior to the step of transducing the enrichedpopulation of cells with a vector encoding a recombinant CAR protein. Inembodiments, the enriched population of cells is cultured for fewer than4 days prior to the step of transducing the enriched population of cellswith a vector encoding a recombinant CAR protein. In embodiments, theenriched population of cells is cultured for fewer than 3 days prior tothe step of transducing the enriched population of cells with a vectorencoding a recombinant CAR protein. In embodiments, the enrichedpopulation of cells is cultured for fewer than 2 days prior to the stepof transducing the enriched population of cells with a vector encoding arecombinant CAR protein. In embodiments, the enriched population ofcells is cultured for fewer than 1 day prior to the step of transducingthe enriched population of cells with a vector encoding a recombinantCAR protein.

In embodiments, the method further includes expanding the CMV specific Tcells expressing a recombinant CAR protein by exposing the T cells to anantigen that binds to the recombinant CAR protein.

In embodiments, the step of expanding the CMV-specific T cellsexpressing a recombinant CAR protein includes exposing the cells to Tcells expressing the antigen that binds the recombinant CAR protein.

In embodiments, the expansion takes place in the presence of at leastone exogenously added interleukin. In embodiments, the expansion takesplace in the presence of at least 2 exogenously added interleukins. Inembodiments, the expansion takes place in the presence of at least 3exogenously added interleukins. In embodiments, the expansion takesplace in the presence of at least 4 exogenously added interleukins. Inembodiments, the expansion takes place in the presence of at least 5exogenously added interleukins. In embodiments, the expansion takesplace in the presence of at least 6 exogenously added interleukins. Inembodiments, the expansion takes place in the presence of at least 7exogenously added interleukins. In embodiments, the expansion takesplace in the presence of at least 8 exogenously added interleukins. Inembodiments, the expansion takes place in the presence of at least 9exogenously added interleukins. In embodiments, the expansion takesplace in the presence of at least 10 exogenously added interleukins.

In embodiments, the population of human T cells is autologous to thesubject. In embodiments, the population of human T cells is allogeneicto the subject.

In embodiments, the method reduces the risk of CMV infection. Inembodiments, the method reduces CMV viremia and/or disease. Inembodiments, the method reduces CMV viremia. In embodiments, the methodreduces CMV disease.

In embodiments, the subject was CMV-immune prior to treatment and themethod reduces the risk of CMV infection. In embodiments, the subjectwas CMV-immune prior to treatment and the method reduces the risk of CMVinfection.

In an aspect is provided a method for treating a disease in a subject inneed thereof including: (i) administering to a subject a therapeuticallyeffective amount of a composition including a population of human Tcells expressing a T cell receptor specific for a viral antigen and arecombinant chimeric antigen receptor (CAR) protein, wherein therecombinant CAR protein includes: (A) an antibody region including acentral cavity formed by a heavy chain variable (VH) region, a lightchain variable (VL) region, a heavy chain constant region (CH) and alight chain constant region (CL), wherein the central cavity forms apeptide binding site including framework region amino acid residues; and(B) a transmembrane domain; and (ii) administering to the subject theviral antigen either prior to or subsequent to administering thecomposition including a population of human T cells to the subject.

In embodiments, the viral antigen is an endogenous viral antigen.

In an aspect is provided a cell including a T cell receptor specific fora cytomegalovirus (CMV) antigen and a recombinant CAR protein, whereinthe recombinant CAR protein includes: (A) an antibody region including acentral cavity formed by a heavy chain variable (VH) region, a lightchain variable (VL) region, a heavy chain constant region (CH) and alight chain constant region (CL), wherein the central cavity forms apeptide binding site including framework region amino acid residues; and(B) a transmembrane domain.

In an aspect is provided a cell including a T cell receptor specific fora viral antigen and a recombinant CAR protein, wherein the recombinantCAR protein includes: (A) an antibody region including a central cavityformed by a heavy chain variable (VH) region, a light chain variable(VL) region, a heavy chain constant region (CH) and a light chainconstant region (CL), wherein the central cavity forms a peptide bindingsite including framework region amino acid residues; and (B) atransmembrane domain.

Provided herein is a method for treating a patient including providing acomposition including a population of T cells expressing both a T cellreceptor specific for a cytomegalovirus (CMV) antigen and a recombinantCAR protein. The recombinant CAR protein includes: (A) an antibodyregion comprising a central cavity formed by a heavy chain variable (VH)region, a light chain variable (VL) region, a heavy chain constantregion (CH) and a light chain constant region (CL), wherein said centralcavity forms a peptide binding site comprising framework region aminoacid residues; and (B) a transmembrane domain. The method includesadministering the composition to the patient; and administering to thepatient a viral vector encoding: (i) CMV pp65 and (ii) a fusion proteincomprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) either prior to or subsequent to administering the compositionincluding a population of T cells to the patient.

In embodiments, the antibody region is an antibody fragment.

In embodiments, the antibody region comprises an Fc domain.

In embodiments, the antibody region is a humanized antibody region.

In embodiments, the recombinant CAR protein further includes anintracellular T-cell signaling domain.

In embodiments, the intracellular T-cell signaling domain is a CD3(intracellular T-cell signaling domain.

In embodiments, the recombinant CAR protein further includes anintracellular co-stimulatory signaling domain.

In embodiments, the intracellular co-stimulatory signaling domain is aCD28 intracellular co-stimulatory signaling domain, a 4-1BBintracellular co-stimulatory signaling domain, a ICOS intracellularco-stimulatory signaling domain, or an OX-40 intracellularco-stimulatory signaling domain.

In embodiments, the recombinant CAR protein further includes a spacerregion.

In embodiments, the spacer region is between said transmembrane domainand the antibody region.

In embodiments, the recombinant CAR protein further includes a linkerdomain.

In embodiments, the linker domain is between said transmembrane domainand the intracellular T-cell signaling domain.

In embodiments, the linker domain is between the intracellular T-cellsignaling domain and the intracellular co-stimulatory signaling domain.

In embodiments, the linker domain includes the sequence GGCGG or GGG.

In embodiments, the recombinant CAR protein is an anti-CD19 protein,anti-CD20 protein, anti-CD22 protein, anti-CD30 protein, anti-CD33protein, anti-CD44v6/7/8 protein, anti-CD123 protein, anti-CEA protein,anti-EGP-2 protein, anti-EGP-40 protein, anti-erb-B2 protein,anti-erb-B2,3,4 protein, anti-FBP protein, anti-fetal acetylcholinereceptor protein, anti-GD2 protein, anti-GD3 protein, anti-Her2/neuprotein, anti-IL-13R-a2 protein, anti-KDR protein, anti k-light chainprotein, anti-LeY protein, anti-L1 cell adhesion molecule protein,anti-MAGE-A1 protein, anti-mesothelin protein, anti-murine CMV infectedcell protein, anti-MUC2 protein, anti-NKGD2 protein, anti, oncofetalantigen protein, anti-PCSA protein, anti-PSMA protein, anti-TAA(targeted by mAb IfE) protein, anti-EGFR protein, anti-TAG-72 protein oranti-VEGF-72 protein.

In embodiments, the step of administering a viral vector to the patientincludes administering recombinant MVA virus.

In embodiments, the expression of (i) CMV pp65 and (ii) the fusionprotein includes exon 4 of CMV protein IE1 (e4) and exon 5 of CMVprotein IE2 (e5) is under the control of mH5 promoter.

In embodiments, the step of providing a population of T cells expressinga T cell receptor specific for a CMV antigen and a recombinant CARprotein includes: (i.i) providing PBMC or a T cell subpopulation from aCMV-seropositive human donor; (ii.i) exposing the PBMC or the T cellsubpopulation to at least one CMV antigen; (iii.i) treating the exposedcells to produce a population of cells enriched for stimulated cellsspecific for CMV; and (iv.i) transducing at least a portion of theenriched population of cells with a vector expressing a recombinant CARprotein.

In embodiments, the step of treating the exposed cells to produce apopulation of cells enriched for stimulated cells specific for CMVincludes treating the stimulated cells to produce a population of cellsenriched for cells expressing an activation marker.

In embodiments, the step of providing a population of T cell expressinga T cell receptor specific for a CMV antigen and a recombinant CARprotein includes: (a) administering a viral vector encoding: (i) CMVpp65 and (ii) a fusion protein including exon 4 of CMV protein IE1 (e4)and exon 5 of CMV protein IE2 (e5) to a human donor to convert aCMV-seronegative human donor to one containing T cells responsive to CMVantigens pp65, IE1 and IE2; (b) obtaining PBMC from the CMV-seropositivehuman donor; (c) exposing the PBMC to at least one CMV antigen; (d)treating the exposed cells to produce a population of cells enriched forstimulated cells specific for CMV; (e) transducing at least a portion ofthe enriched population of cells with a vector expressing a recombinantCAR protein, thereby providing a population of T cell expressing arecombinant CAR protein and a T cell receptor specific for a CMVantigen.

In embodiments, the step of providing a population of T cell expressinga T cell receptor specific for a CMV antigen and a recombinant CARprotein includes: (a) administering a viral vector encoding: (i) CMVpp65 and (ii) a fusion protein comprising exon 4 of CMV protein IE1 (e4)and exon 5 of CMV protein IE2 (e5) to a CMV-seropositive human donor;(b) obtaining PBMC from the CMV-seropositive human donor; (b) exposingthe PBMC to at least one CMV antigen; (c) treating the exposed cells toproduce a population of cells enriched for stimulated cells specific forCMV; (d) transducing at least a portion of the enriched population ofcells with a vector expressing a recombinant CAR protein, therebyproviding a population of T cell expressing a recombinant CAR proteinand a T cell receptor specific for a CMV antigen.

Also provided herein is a method for preparing T cells expressing arecombinant CAR protein and a T cell receptor specific for a CMVantigen. The method includes: (a) administering a viral vector encoding:(i) CMV pp65 and (ii) a fusion protein comprising exon 4 of CMV proteinIE1 (e4) and exon 5 of CMV protein IE2 (e5) to a CMV-seropositive humandonor; (b) obtaining PBMC from the CMV-seropositive human donor; (b)exposing the PBMC to at least one CMV antigen; (c) treating the exposedcells to produce a population of cells enriched for stimulated cellsspecific for CMV; (d) transducing at least a portion of the enrichedpopulation of cells with a vector expressing a recombinant CAR protein,thereby providing a population of T cell expressing a recombinant CARprotein and a T cell receptor specific for a CMV antigen.

Also provided herein is a method for preparing T cells expressing arecombinant CAR protein and a T cell receptor specific for a CMVantigen. The method includes: a) administering a viral vector encoding:(i) CMV pp65 and (ii) a fusion protein comprising exon 4 of CMV proteinIE11 (e4) and exon 5 of CMV protein IE2 (e5) to a CMV-seropositive humandonor; (b) obtaining PBMC from the CMV-seropositive human donor; (b)exposing the PBMC to at least one CMV antigen; (c) treating the exposedcells to produce a population of cells enriched for stimulated cellsspecific for CMV; (d) transducing at least a portion of the enrichedpopulation of cells with a vector expressing a recombinant CAR protein,thereby providing a population of T cell expressing a recombinant CARprotein and a T cell receptor specific for a CMV antigen.

Also provided herein is a method for treating a patient. The methodincludes: (a) providing a composition comprising a population of T cellsexpressing both a T cell receptor specific for a viral antigen and arecombinant CAR protein. The recombinant CAR protein includes: (A) anantibody region comprising a central cavity formed by a heavy chainvariable (VH) region, a light chain variable (VL) region, a heavy chainconstant region (CH) and a light chain constant region (CL), whereinsaid central cavity forms a peptide binding site comprising frameworkregion amino acid residues; and (B) a transmembrane domain. The methodincludes administering the composition to the patient; and administeringto the patient said viral antigen either prior to or subsequent toadministering the composition comprising a population of T cells to thepatient.

In embodiments, the viral antigen is an endogenous viral antigen.

Also provided herein is a cell including a T cell receptor specific fora cytomegalovirus (CMV) antigen and a recombinant CAR protein. Therecombinant CAR protein includes: (A) an antibody region comprising acentral cavity formed by a heavy chain variable (VH) region, a lightchain variable (VL) region, a heavy chain constant region (CH) and alight chain constant region (CL), wherein said central cavity forms apeptide binding site comprising framework region amino acid residues;and (B) a transmembrane domain.

Also provided herein is a cell including a T cell receptor specific fora viral antigen and a recombinant CAR protein. The recombinant CARprotein includes: (A) an antibody region comprising a central cavityformed by a heavy chain variable (VH) region, a light chain variable(VL) region, a heavy chain constant region (CH) and a light chainconstant region (CL), wherein said central cavity forms a peptidebinding site includes a framework region amino acid residues; and (B) atransmembrane domain.

In one aspect, an isolated nucleic acid is provided. The nucleic acidencodes a protein including (i) an antibody region including a centralcavity formed by a heavy chain variable (VH) region, a light chainvariable (VL) region, a heavy chain constant region (CH) and a lightchain constant region (CL), wherein the central cavity forms a peptidebinding site including framework region amino acid residues; and (ii) atransmembrane domain.

In one aspect, an isolated nucleic acid is provided. The nucleic acidencodes a protein including (i) an antibody region including a centralcavity formed by a heavy chain variable (VH) region and a light chainvariable (VL) region, wherein the central cavity forms a peptide bindingsite including framework region amino acid residues; and (ii) atransmembrane domain.

In another aspect, an isolated nucleic acid is provided. The isolatednucleic acid encodes a protein including a first portion including anantibody heavy chain variable domain and a second portion including anantibody light chain variable domain and an antibody light chainconstant domain, wherein the first portion further includes atransmembrane domain.

In another aspect, an expression vector including a nucleic acidprovided herein including embodiments thereof is provided.

In another aspect, a T lymphocyte including the expression vectorprovided herein including embodiments thereof is provided.

In another aspect, a mammalian cell including the expression vectorprovided herein including embodiments thereof is provided.

In another aspect, a recombinant protein is provided. The recombinantprotein includes (i) an antibody region including a central cavityformed by a heavy chain variable (VH) region and a light chain variable(VL) region, wherein the central cavity forms a peptide binding siteincluding framework region amino acid residues; and (ii) a transmembranedomain.

In another aspect, a recombinant protein is provided. The recombinantprotein includes a first portion including an antibody heavy chainvariable domain and a second portion including an antibody light chainvariable domain and an antibody light chain constant domain, wherein thefirst portion further includes a transmembrane domain, and wherein theantibody heavy chain variable domain, the antibody light chain variabledomain and the antibody light chain constant domain together form anantibody region.

In another aspect, a mammalian cell including the recombinant proteinprovided herein including embodiments thereof is provided, wherein thetransmembrane domain is within the cell membrane of the mammalian cell.

In another aspect, a T lymphocyte including the recombinant proteinprovided herein including embodiments thereof is provided, wherein thetransmembrane domain is within the cell membrane of the T lymphocyte.

In another aspect, a method of treating cancer is provided. The methodincludes administering to a subject in need thereof an effective amountof a mammalian cell provided herein including embodiments thereof,wherein the antibody region is an anti-cancer antibody region.

In another aspect, a method of treating cancer is provided. The methodincludes administering to a subject in need thereof an effective amountof the T-lymphocyte provided herein including embodiments thereof,wherein the antibody region is an anti-cancer antibody region.

In another aspect, a method of reprogramming a T lymphocyte is provided.The method includes contacting a T lymphocyte with the expression vectorprovided herein including embodiments thereof.

In another aspect, a method of detecting a cancer is provided. Themethod includes (i) administering to a cancer patient an effectiveamount of a T lymphocyte including the recombinant protein providedherein including embodiments thereof and a compound including a peptidylmoiety capable of binding to the peptide binding site, wherein thecompound further includes a detectable label, and wherein the antibodyregion is an anti-cancer antibody region. The method includes (ii)allowing the compound to bind to the peptide binding site therebyforming a recombinant protein-compound complex. And (iii) therecombinant protein-compound complex is detected within the cancerpatient thereby detecting the cancer.

Recombinant Nucleic Acids Encoding Recombinant Car Protein

Provided herein are compositions which exhibit novel diagnosticcapabilities and allow to rapidly add functionality to adoptiveimmunotherapy. The recombinant proteins (i.e. recombinant CAR proteins)provided herein are useful, inter alia, for a broad variety oftherapeutic and diagnostic purposes. For example, the recombinantproteins provided herein including embodiments thereof may be used asnon-invasive means to characterize chimeric antigen receptor (CAR) Tcells before and/or during treatment of diseases (e.g., cancer). Byadding functionality to the CAR immunoreceptors a population of patientswith antigen-positive tumors can be efficiently treated and monitoredirrespective of their HLA genotype. Adoptive immunotherapy using Tlymphocytes that express these functionally improved tumor-specific CARscan be a powerful therapeutic strategy for the treatment of cancer andother diseases (e.g., infectious diseases (e.g., HIV infection)).Further, using the recombinant proteins provided herein includingembodiments thereof allow for testing and improvement of thefunctionality and safety of CAR T cells.

In another aspect, an isolated nucleic acid is provided. The nucleicacid encodes a recombinant CAR protein including (i) an antibody regionincluding a central cavity formed by a heavy chain variable (VH) regionand a light chain variable (VL) region, wherein the central cavity formsa peptide binding site including framework region amino acid residues;and (ii) a transmembrane domain.

An “antibody region” as provided herein refers to a monovalent ormultivalent protein moiety that forms part of the protein (i.e.recombinant CAR protein) provided herein including embodiments thereof.A person of ordinary skill in the art would therefore immediatelyrecognize that the antibody region is a protein moiety capable ofbinding an antigen (epitope). Thus, the antibody region provided hereinmay include a domain of an antibody or fragment (e.g., Fab) thereof. Inembodiments, the antibody region is a protein conjugate. A “proteinconjugate” a provided herein refers to a construct consisting of morethan one polypeptide, wherein the polypeptides are bound togethercovalently or non-covalently. In embodiments, the protein conjugateincludes a Fab moiety (a monovalent Fab) covalently attached to an scFvmoiety (a monovalent scFv). In embodiments, the protein conjugateincludes a plurality of (at least two) Fab moieties. In embodiments, thepolypeptides of a protein conjugate are encoded by one nucleic acidmolecule. In embodiments, the polypeptides of a protein conjugate areencoded by different nucleic acid molecules. In embodiments, thepolypeptides are connected through a linker. In embodiments, thepolypeptides are connected through a chemical linker.

In embodiments, the antibody region includes a plurality of variablelight chain domains and a plurality of variable heavy chain domains. A“variable light chain domain” as provided herein refers to a polypeptideincluded in (forming part of) a light chain variable (VL) region. Inembodiments, the variable light chain region is a light chain variable(VL) domain. A “variable heavy chain domain” as provided herein refersto a polypeptide included in (forming part of) a heavy chain variable(VH) region. In embodiments, the variable heavy chain region is a heavychain variable (VH) domain. In embodiments, each of said plurality ofvariable light chain domains and plurality of variable heavy chaindomains is chemically different. Where the plurality of variable lightchain domains and plurality of variable heavy chain domains ischemically different, each of the variable light chain domains and thevariable heavy chain domains bind a different antigen (epitope). Theantigens bound by chemically different variable light chain domains anddifferent variable heavy chain domains may form part of the same proteinor a different protein. In embodiments, the antigen forms part of acancer cell. In embodiments, the antibody region includes a firstvariable light chain domain and a first variable heavy chain domain anda second variable light chain domain and a second variable heavy chaindomain. The first variable heavy chain domain and the first variablelight chain domain form a first paratope binding a first epitope and thesecond variable heavy chain domain and the second variable light chaindomain form a second paratope binding to a second epitope, wherein thefirst and the second paratope are independently different. The term“paratope” refers to the antigen binding site of an antibody or fragmentthereof.

In embodiments, the antibody region includes a first variable lightchain domain and a first variable heavy chain domain, a second variablelight chain domain and a second variable heavy chain domain, a thirdvariable light chain domain and a third variable heavy chain domain, anda forth variable light chain domain and a forth variable heavy chaindomain. The first variable heavy chain domain and the first variablelight chain domain form a first paratope binding a first epitope, thesecond variable heavy chain domain and the second variable light chaindomain form a second paratope binding to a second epitope, the thirdvariable heavy chain domain and the third variable light chain domainform a third paratope binding a third epitope, the forth variable heavychain domain and the forth variable light chain domain form a forthparatope binding to a second epitope, wherein the first, the second, thethird and the forth paratope are independently different.

In embodiments, the first, the second, the third and the forth paratopeare connected through a chemical linker. In embodiments, the chemicallinker is a covalent linker, a non-covalent linker, a peptide linker (alinker including a peptide moiety), a cleavable peptide linker, asubstituted or unsubstituted alkylene, substituted or unsubstitutedheteroalkylene, substituted or unsubstituted cycloalkylene, substitutedor unsubstituted heterocycloalkylene, substituted or unsubstitutedarylene or substituted or unsubstituted heteroarylene or any combinationthereof. Thus, a chemical linker as provided herein may include aplurality of chemical moieties, wherein each of the plurality ofmoieties is chemically different. In embodiments, the linker is apeptide linker. In embodiments, the peptide linker has a length of about5- to about 15 amino acid residues.

In embodiments, the antibody region is a bispecific antibody. Inembodiments, the antibody region is a tetravalent antibody. Inembodiments, the antibody region is a tetravalent IgG.

In embodiments, the antibody region is a dual-variable domainimmunoglobulin as described in Jakob C G et al. (MAbs. 2013 May 1; 5(3):358-363) and Byrne H et al. (Cell Volume 31, Issue 11, p 621-632,November 2013), which are hereby incorporated by reference in theirentirety and for all purposes.

In embodiments, the antibody region includes SEQ ID NO:31 and SEQ IDNO:32. In embodiments, the antibody region includes SEQ ID NO:33 and SEQID NO:34. In embodiments, the antibody region includes SEQ ID NO:35 andSEQ ID NO:36. In embodiments, the antibody region includes SEQ ID NO:37and SEQ ID NO:38. In embodiments, the antibody region includes SEQ IDNO:39 and SEQ ID NO:40. In embodiments, the antibody region includes SEQID NO:41 and SEQ ID NO:42. In embodiments, the antibody region includesSEQ ID NO:43 and SEQ ID NO:44. In embodiments, the antibody regionincludes SEQ ID NO:45 and SEQ ID NO:46. In embodiments, the antibodyregion includes SEQ ID NO:47 and SEQ ID NO:48. In embodiments, theantibody region includes SEQ ID NO:49 and SEQ ID NO:50. In embodiments,the antibody region includes SEQ ID NO:51 and SEQ ID NO:52. Inembodiments, the antibody region includes SEQ ID NO:53 and SEQ ID NO:54.In embodiments, the antibody region includes SEQ ID NO:55 and SEQ IDNO:56. In embodiments, the antibody region includes SEQ ID NO:57 and SEQID NO:58. In embodiments, the antibody region includes SEQ ID NO:59 andSEQ ID NO:60. In embodiments, the antibody region includes SEQ ID NO:61and SEQ ID NO:62. In embodiments, the antibody region includes SEQ IDNO:63 and SEQ ID NO:64. In embodiments, the antibody region includes SEQID NO:65 and SEQ ID NO:66. In embodiments, the antibody region includesSEQ ID NO:67 and SEQ ID NO:68. In embodiments, the antibody regionincludes SEQ ID NO:69 and SEQ ID NO:70. In embodiments, the antibodyregion includes SEQ ID NO:71 and SEQ ID NO:72. In embodiments, theantibody region includes SEQ ID NO:73 and SEQ ID NO:74. In embodiments,the antibody region includes SEQ ID NO:75 and SEQ ID NO:76. Inembodiments, the antibody region includes SEQ ID NO:77 and SEQ ID NO:78.In embodiments, the antibody region includes SEQ ID NO:79 and SEQ IDNO:80. In embodiments, the antibody region includes SEQ ID NO:81 and SEQID NO:82. In embodiments, the antibody region includes SEQ ID NO:87 andSEQ ID NO:88. In embodiments, the antibody region includes SEQ ID NO:89and SEQ ID NO:90. In embodiments, the antibody region includes SEQ IDNO:91 and SEQ ID NO:92. In embodiments, the antibody region includes SEQID NO:93 and SEQ ID NO:94. In embodiments, the antibody region includesSEQ ID NO:95 and SEQ ID NO:96.

The “heavy chain variable (VH) region” as provided herein is apolypeptide which includes the variable domain of a heavy chain of anantibody or a fragment thereof. Likewise, the “light chain variable (VL)region” as provided herein is a polypeptide including the variabledomain of a light chain of an antibody or a fragment thereof. Inembodiments, the heavy chain variable (VH) region is the variable regionof the heavy chain of an antibody. In embodiments, the heavy chainvariable (VH) region is the variable region of the heavy chain of anantibody fragment. In embodiments, the heavy chain variable (VH) regionis the variable region of the heavy chain of a Fab. In embodiments, thelight chain variable (VL) region is the variable region of the lightchain of an antibody. In embodiments, the light chain variable (VL)region is the variable region of the light chain of an antibodyfragment. In embodiments, the light chain variable (VL) region is thevariable region of the light chain of a Fab.

In embodiments, the antibody region further includes a heavy chainconstant region (CH) and a light chain constant region (CL). Inembodiments, the heavy chain constant region (CH) is the constant regionof the heavy chain of an antibody or fragment thereof. In embodiments,the light chain constant region (CL) is the constant region of the lightchain of an antibody or fragment thereof. In embodiments, the heavychain constant region (CH) is the constant region of a Fab. Inembodiments, the light chain constant region (CL) is the constant regionof the light chain of a Fab. In embodiments, the heavy chain constantregion (CH) is the constant region of a F(ab)′2 dimer. In embodiments,the light chain constant region (CL) is the constant region of the lightchain of a F(ab)′2 dimer. In embodiments, the antibody region includesan Fc domain. In embodiments, the antibody region is a humanizedantibody region. In embodiments, the antibody region is a humanizedmouse antibody region. In embodiments, the antibody region does notinclude an scFV antibody region. Where the antibody region does notinclude a scFv antibody region, the antibody region does not include afusion protein of the variable regions of the heavy (VH) and lightchains (VL) of immunoglobulins, connected with a short linker peptide.

The “central cavity” with respect to the three-dimensional structure ofa Fab, refers to the internal cavity of the Fab lined by portions of theheavy and light chain variable and constant regions and including aminoacids lining a hole within the cavity. In embodiments, the centralcavity including the hole has a structure, e.g., as depicted in, orsimilar to, FIG. 4A. In embodiments, where the antibody region includesa Fab, the central cavity thus is lined by residues of the VH, VL, CH1,and CL regions. The central cavity does not include the antigen bindingsite. Thus, in embodiments the compound that binds to the central cavitydoes not impact (e.g. measurably impact) the binding of the antibodyregion to the epitope. In other words, in embodiments, occupancy of thissite does not affect antigen binding. In embodiments, the central cavityis lined by amino acid residues capable of interacting with a compoundincluding a peptidyl moiety (e.g. a meditope) provided herein includingembodiments thereof (e.g., a peptide of formula (I) or (II)). The aminoacids residues capable of interacting with the compound including apeptidyl moiety (e.g. a meditope) may from part of the peptide bindingsite (also referred to herein as a meditope binding site). The peptidebinding site may be engineered into any appropriate antibody therebyforming an antibody or antibody region with the peptide binding site(also referred to herein as a meditope enabled antibody or meditopeenabled antibody region).

In embodiments, the amino acid residues lining the central cavityinclude a residue at a position corresponding to Kabat position 83, aresidue at a position corresponding to Kabat position 30 or a residue ata position corresponding to Kabat position 52. In embodiments, the aminoacid residues lining the central cavity include a residue at a positioncorresponding to Kabat position 40, a residue at a positioncorresponding to Kabat position 41, a residue at a positioncorresponding to Kabat position 30, a residue at a positioncorresponding to Kabat position 52, a residue at a positioncorresponding to Kabat position 83, or a residue at a positioncorresponding to Kabat position 85. In embodiments, the amino acidresidues lining the central cavity include a residue at a positioncorresponding to Kabat position 40. In embodiments, the amino acidresidues lining the central cavity include a residue at a positioncorresponding to Kabat position 41. In embodiments, the amino acidresidues lining the central cavity include a residue at a positioncorresponding to Kabat position 30. In embodiments, the amino acidresidues lining the central cavity include a residue at a positioncorresponding to Kabat position 52. In embodiments, the amino acidresidues lining the central cavity include a residue at a positioncorresponding to Kabat 83. In embodiments, the amino acid residueslining the central cavity include a residue at a position correspondingto Kabat position 85.

In embodiments, the amino acid residues lining the central cavityinclude a residue at a position corresponding to Kabat position 30. Inembodiments, the residue at a position corresponding to Kabat position30 is a negatively charged amino acid residue. In embodiments, theresidue at a position corresponding to Kabat position 30 is asparticacid. In embodiments, the amino acid residues lining the central cavityinclude a residue at a position corresponding to Kabat position 52. Inembodiments, the residue at a position corresponding to Kabat position52 is a negatively charged amino acid residue. In embodiments, theresidue at a position corresponding to Kabat position 52 is asparticacid. In embodiments, the amino acid residues lining the central cavityinclude a residue at a position corresponding to Kabat position 83. Inembodiments, the residue at a position corresponding to Kabat position83 is a negatively charged amino acid residue. In embodiments, theresidue at a position corresponding to Kabat position 83 is glutamicacid. In embodiments, the residue at a position corresponding to Kabatposition 83 is isoleucine. In embodiments, the amino acid residueslining the central cavity include a residue at a position correspondingto Kabat position 85.

In embodiments, the central cavity is lined by (formed by) a light chainresidue at a position corresponding to Kabat position Gln38, Thr40,Gln41, Gly42, Ser43, Asp 52, Asp85, Ile83, Tyr87, Lys103, Val163,Thr164, or Glu165. A “light chain residue” as provided herein refers toa residue forming part of a light chain of an antibody or antibodyfragment. In embodiments, the central cavity is lined (e.g., formed) bya light chain residue at a position corresponding to Kabat positionGln38. In embodiments, the central cavity is lined (e.g., formed) by alight chain residue at a position corresponding to Kabat position Thr40In embodiments, the central cavity is lined (e.g., formed) by a lightchain residue at a position corresponding to Kabat position Gln41. Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position Gly42. Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position to Ser43. Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position Asp85. Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position Tyr87. Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position Lys103. Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position Val163. Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position Thr164 Inembodiments, the central cavity is lined (e.g., formed) by a light chainresidue at a position corresponding to Kabat position Glu165.

In embodiments, the central cavity is lined by (formed by) a heavy chainresidue at a position corresponding to Kabat position Asp 30, Gln39,Pro40, Thr91, Ala92, Ile93, Tyr95, Gln112, Leu115, Glu155, Pro156,Pro174, Ala175, or Tyr183. A “heavy chain residue” as provided hereinrefers to a residue forming part of a heavy chain of an antibody orantibody fragment. In embodiments, the central cavity is lined (e.g.,formed) by a heavy chain residue at a position corresponding to Kabatposition Gln39. In embodiments, the central cavity is lined (e.g.,formed) by a heavy chain residue at a position corresponding to Kabatposition. In embodiments, the central cavity is lined (e.g., formed) bya heavy chain residue at a position corresponding to Kabat positionPro40. In embodiments, the central cavity is lined (e.g., formed) by aheavy chain residue at a position corresponding to Kabat position Thr91.In embodiments, the central cavity is lined (e.g., formed) by a heavychain residue at a position corresponding to Kabat position Ala92. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Ile93. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Tyr95. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Gln112. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Leu115. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Glu155. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Pro156. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Pro174. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Ala175. Inembodiments, the central cavity is lined (e.g., formed) by a heavy chainresidue at a position corresponding to Kabat position Tyr183.

The central cavity provided herein includes a peptide binding site (alsoreferred to herein as a meditope binding site) including frameworkregion amino acid (FR) residues. In embodiments, the peptide bindingsite does not include CDR residues of the heavy chain or the lightchain. In embodiments, the peptide binding site includes FR residues ofthe heavy chain or the light chain. In embodiments, the peptide bindingsite includes FR residues of the heavy chain and the light chain. Inembodiments, the peptide binding site includes a residue at a positioncorresponding to Kabat position 83, a residue at a positioncorresponding to Kabat position 30 or a residue at a positioncorresponding to Kabat position 52. In embodiments, the peptide bindingsite includes a residue at a position corresponding to Kabat position40, a residue at a position corresponding to Kabat position 41, aresidue at a position corresponding to Kabat position 30, a residue at aposition corresponding to Kabat position 52, a residue at a positioncorresponding to Kabat position 83, or a residue at a positioncorresponding to Kabat position 85. In embodiments, the peptide bindingsite includes a residue at a position corresponding to Kabat position40. In embodiments, the peptide binding site includes a residue at aposition corresponding to Kabat position 41. In embodiments, the peptidebinding site includes a residue at a position corresponding to Kabatposition 30. In embodiments, the peptide binding site includes a residueat a position corresponding to Kabat position 52. In embodiments, thepeptide binding site includes a residue at a position corresponding toKabat position 83. In embodiments, the peptide binding site includes aresidue at a position corresponding to Kabat position 85. Inembodiments, residues forming a peptide binding site are described inpublished US application US20120301400 A1, which is hereby incorporateby reference in its entirety and for all purposes.

In embodiments, the central cavity is lined by amino acid residuescapable of binding a compound including a peptidyl moiety. Thus, inembodiments, the peptide binding site provided herein is capable ofbinding a compound including a peptidyl moiety. In embodiments, thepeptide binding site is capable of binding the peptidyl moiety. Inembodiments, the peptide binding site provided herein is bound to acompound including a peptidyl moiety. In embodiments, the peptidebinding site is bound to the peptidyl moiety. In embodiments, thepeptidyl moiety is a moiety as described in published US applicationUS20120301400 A1 and Avery et al. 2015 (Scientific Reports 5:7817) whichare hereby incorporated by reference in their entirety and for allpurposes.

In embodiments, the compound that binds to the peptide binding site is apeptide or includes a peptidyl moiety. In embodiments, the compound is asubstituted peptide. In embodiments, the peptide is between 5 and 16amino acids in length. In embodiments, the compound includes asubstituted peptidyl moiety. In embodiments, the peptidyl moiety isbetween 5 and 16 amino acids in length. The peptide or peptidyl moietyprovided herein may also be referred to as a “meditope.” In embodiments,the peptide or peptidyl moiety has the formula:X1-X2-X3-X4-X5-X6-X7-X8-X9-X10-X11-X12  (I).Where the sequence of Formula (I) is a peptidyl moiety, a person havingordinary skill in the art will immediately understand that the peptidylmoiety is attached to the remainder of the compound at one or moreattachments points. In formula (I), X1 is Cys, Gly, β-alanine,2,3-diaminopropionic acid, β-azidoalanine, or null; X2 is Gln or null;X3 is Phe, Tyr, β-β′-diphenyl-Ala, His, Asp, 2-bromo-L-phenylalanine,3-bromo-L-phenylalanine, 4-bromo-L-phenylalanine, Asn, Gln, a modifiedPhe, a hydratable carbonyl-containing residue or a boronicacid-containing residue; X4 is Asp or Asn; X5 is Leu; β-β′-diphenyl-Ala,Phe, a non-natural analog of phenylalanine, tryptophan, tyrosine, ahydratable carbonyl-containing residue or a boronic acid-containingresidue; X6 is Ser or Cys; X7 is Thr, Ser or Cys; X8 is Arg, a modified(substituted) Arg, a hydratable carbonyl or a boronic acid-containingresidue; X9 is Arg or Ala; X10 is Leu, Gln, Glu, β-β′-diphenyl-Ala, Phe,a non-natural analog of phenylalanine, tryptophan, tyrosine, ahydratable carbonyl-containing residue or a boronic acid-containingresidue; X11 is Lys; and X12 is Cys, Gly, 7-aminoheptanoic acid,β-alanine, diaminopropionic acid, propargylglycine, isoaspartic acid ornull; wherein the modified Phe is a Phe with one or more halogenincorporated into the phenyl ring and wherein the modified Arg has astructure of the formula:

In formula (IA), R, R′ and R″ are independently substituted orunsubstituted alkyl, substituted or unsubstituted aryl, substituted orunsubstituted heteroaryl, or NHR′″ and R′″ is substituted orunsubstituted alkyl, substituted or unsubstituted aryl, substituted orunsubstituted heteroaryl. In embodiments, R′″ is unsubstituted alkyl,unsubstituted aryl or unsubstituted heteroaryl.

In embodiments, the peptide is a cyclic peptide. In embodiments, thepeptidyl moiety is a cyclic peptidyl moiety. In embodiments, the peptideor peptidyl moiety includes a disulfide bridge, a thioether bridge, alactam linkage, cycloaddition. In embodiments, the cyclic portion of thecyclic peptide or cyclic peptidyl moiety is formed through bindingbetween X1 and X12, X1 and X11, X3 and X11, X4 and X11, or X2 and X12.In embodiments, the non-natural amino acid is β-β′-diphenyl-Ala,branched alkyl, substituted or unsubstituted aryl or substituted orunsubstituted heteroaryl. In embodiments, each of the one or morehalogen is an ortho-, meta-, or para-bromo phenyl substituent.

In embodiments, the peptide or peptidyl moiety has the formula:

In formula (II), R³ is hydrogen, R^(3A)-substituted or unsubstitutedaryl, wherein R^(3A) is hydrogen, halogen or C₁₋₄ unsubstituted alkyl.R^(3′) is hydrogen, R^(3A′)-substituted or unsubstituted aryl, whereinR^(3A′) is hydrogen, halogen or C₁₋₄ unsubstituted alkyl. R⁵ isR^(5A)-substituted or unsubstituted C₁₋₈ (e.g., C₁₋₄) alkyl. R^(5A) isoxo, acetal, ketal, —B(OH)₂, boronic ester, phosphonate ester, orthoester, —CO₂C₁₋₄ alkyl, —CH═CH—CHO, —CH═CH—C(O)R^(5A′),—CH═CH—CO₂R^(5A′), —CO₂H, —CONH₂, or R^(5A″)-substituted orunsubstituted aryl, R^(5A″)-substituted or unsubstituted heteroaryl(e.g., naphthyl, imidazole, indole), wherein R^(5A′) is substituted orunsubstituted C₁₋₄ alkyl and R^(5A″) is —OH, fluoro, chloro, bromo oriodo. R⁶ is -L^(6′)OH or -L^(6′)SH, wherein L^(6′) is substituted orunsubstituted C₁₋₄ alkylene. R⁷ is -L^(7′)OH or -L^(7′)SH, whereinL^(7′) is substituted or unsubstituted C₁₋₄ alkyl. The symbol m is 0, 1,2, 3, 4, or 5.

In formula (II), R⁸ is —OH, —NR^(a)R^(b), —N(R^(c))C(O)R^(c), or—N(R^(c))C(═NR^(d))R^(c). R^(a) is H. R^(b) is H or C₁₋₈ alkyloptionally substituted with one or more substituents selected from thegroup consisting of oxo, acetal, and ketal, —B(OH)₂, —SH, boronic ester,phosphonate ester, ortho ester, —CH═CH—CHO, —CH═CH—C(O)C₁₋₄ alkyl,—CH═CH—CO₂C₁₋₄ alkyl, —CO₂H, or —CO₂C₁₋₄ alkyl group. R^(c) is H, C₁₋₈alkyl, C₃₋₈ cycloalkyl, branched alkyl, or aryl. R^(d) is H or a C₁₋₈alkyl, C_(2-g) alkenyl, C₂₋₈ alkynyl, C₃₋₈ cycloalkyl, branched alkyl,or aryl group, each optionally substituted with one or more substituentsselected from the group consisting of —N₃, —NH₂, —OH, —SH, halogen, oxo,acetal, ketal, —B(OH)₂, boronic ester, phosphonate ester, ortho ester,—CH═CH—CHO, —CH═CH—C(O)C₁₋₄alkyl, —CH═CH—CO₂C₁₋₄alkyl, —CO₂H, and—CO₂C₁₋₄ alkyl group. R^(e) is H, —NHR^(d); or a C₁₋₁₂ alkyl, C₃₋₈cycloalkyl, C₂₋₁₂ alkenyl, C₂₋₈ alkynyl, or aryl group, each optionallysubstituted with one or more substituents selected from the groupconsisting of —N₃, —NH₂, —OH, —SH, oxo, C₂₋₄ acetal, C₂₋₄ ketal,—B(OH)₂, boronic ester, phosphonate ester, ortho ester, —CH═CH—CHO,—CH═CH—C(O)C₁₋₄ alkyl, —CH═CH—CO₂C₁₋₄ alkyl, and —CO₂C₁₋₄ alkyl group.

In formula (II), R⁹ is substituted or unsubstituted C₁₋₄ alkyl. R¹⁰ isR^(10A)-substituted or unsubstituted C₁₋₈ alkyl, wherein R^(10A) is oxo,acetal, ketal, —B(OH)₂, boronic ester, phosphonate ester, ortho ester,—CH═CH—CHO, —CH═CH—C(O)C₁₋₄ alkyl, —CH═CH—CO₂C₁₋₄ alkyl, —CO₂C₁₋₄ alkyl,—CO₂H, —CONH₂, R^(10B)-substituted or unsubstituted phenyl,R^(10B)-substituted or unsubstituted naphthyl, R^(10B)-substituted orunsubstituted imidazolyl, or R^(10B)-substituted or unsubstitutedindolyl, wherein R^(10B) is —OH or halogen. The symbol n is 0 or 1. Thesymbol p is 0 or 1.

In formula (II), X is R^(X)-substituted or unsubstituted C₁₋₈ alkylene,R^(x)-substituted or unsubstituted C₂₋₈ alkenylene, R^(x) is oxo, —C(O),—NH₂, —NHC(O) or —NHC(O)R^(y), wherein one carbon of the alkenylene isoptionally replaced with —C(O)NH, a 5-membered heteroarylene, or —S—S,and R^(y) is —C₁₋₄ alkyl, —CH(R^(z))C(O) or —CH(R^(z))CO₂H, whereinR^(z) is —H or R^(z′)-substituted or unsubstituted —C₁₋₄ alkyl, whereinR^(z′) is —OH, —SH, or —NH₂. Formula (I) or (II) includes allappropriate pharmaceutically acceptable salts. More informationregarding the concepts of peptide binding sites (meditope binding sites)and peptides (meditopes) can be found in international applicationserial no. PCT/US2011/055656, PCT/US2015/053880, PCT/US2012/032938 andUS application serial no. U.S. Ser. No. 14/453,586, which are herebyincorporated in their entirety and for all purposes.

The compounds provided herein may include a therapeutic agent, adiagnostic agent or a detectable agent (also referred to herein as adetectable agent) attached to the peptidyl moiety. In embodiments, thecompound is conjugated to a therapeutic agent, a diagnostic agent, or adetectable agent. In embodiments, the peptidyl moiety (e.g., the peptideof formula (I) or (II)) is conjugated to a therapeutic agent, adiagnostic agent or a detectable agent. In embodiments, the antibodyregion is conjugated to a therapeutic agent, a diagnostic agent, or adetectable agent.

The therapeutic agent, diagnostic agent or detectable agent may beattached through a chemical linker to the compound (e.g. to the peptidylmoiety) and/or the antibody region provided herein including embodimentsthereof. In embodiments, the chemical linker is a covalent linker, anon-covalent linker, a peptide linker (a linker including a peptidemoiety), a cleavable peptide linker, a substituted or unsubstitutedalkylene, substituted or unsubstituted heteroalkylene, substituted orunsubstituted cycloalkylene, substituted or unsubstitutedheterocycloalkylene, substituted or unsubstituted arylene or substitutedor unsubstituted heteroarylene or any combination thereof.

A chemical linker as provided herein may include a plurality of chemicalmoieties, wherein each of the plurality of moieties is chemicallydifferent. In embodiments, the therapeutic agent, diagnostic agent ordetectable agent is attached to the compound through a non-covalent orcovalent linker. In embodiments, the therapeutic agent, diagnostic agentor detectable agent is attached to the peptidyl moiety through anon-covalent or covalent linker. In embodiments, the therapeutic agent,diagnostic agent or detectable agent is attached to the antibody regionthrough a non-covalent or covalent linker. Typically, the linker may bea covalent linker as described herein and formed through conjugate (e.g.“click”) chemistry. The linker may further be a cleavable peptide linkeras described herein. Where the therapeutic, diagnostic or detectableagent forms part (e.g., through covalent attachment) of the compound,the peptidyl moiety and/or the antibody region provided herein,including embodiments thereof, the therapeutic, diagnostic or detectableagent may be referred to as a “therapeutic moiety”, “diagnostic moiety”,or “detectable moiety”, respectively. In embodiments, the peptide moiety(meditope) contains a reactive amine functionality (e.g., Lysl 1), whichis used for conjugation of the meditope (peptidyl moiety), e.g., to ascaffold or linker or to a functional moiety, such as a diagnostic,e.g., imaging, agent or therapeutic moiety as described herein. Inembodiments, thiol functionalities are introduced in any suitableposition on the meditope (peptidyl moiety) and are selectively modifiedusing reagents containing imagining agents, other proteins and peptides,metal chelators, siRNAs, nanoparticles, and cytotoxic drugs. Coupling oftherapeutic or diagnostic moieties to the peptidyl moiety providedherein can be performed using peptide chemistry methodology well knownin the art and described, for example in WO 2013055404 A1, which ishereby incorporated by reference for all purposes and its entirety.

Therapeutic moieties as provided herein may include, without limitation,peptides, proteins, nucleic acids, nucleic acid analogs, smallmolecules, antibodies, enzymes, prodrugs, cytotoxic agents (e.g. toxins)including, but not limited to ricin, doxorubicin, daunorubicin, taxol,ethidium bromide, mitomycin, etoposide, tenoposide, vincristine,vinblastine, colchicine, dihydroxy anthracin dione, actinomycin D,diphteria toxin, Pseudomonas exotoxin (PE) A, PE40, abrin, andglucocorticoid. In embodiments, the therapeutic moiety is an anti-canceragent or chemotherapeutic agent as described herein. In embodiments, thetherapeutic moiety is a nucleic acid moiety, a peptide moiety or a smallmolecule drug moiety. In embodiments, the therapeutic moiety is anucleic acid moiety. In embodiments, the therapeutic moiety is anantibody moiety. In embodiments, the therapeutic moiety is a peptidemoiety. In embodiments, the therapeutic moiety is a small molecule drugmoiety. In embodiments, the therapeutic moiety is a nuclease. Inembodiments, the therapeutic moiety is an immunostimulator. Inembodiments, the therapeutic moiety is a toxin. In embodiments, thetherapeutic moiety is a nuclease.

The compound, peptidyl moiety or antibody region provided herein mayinclude an imaging or detectable moiety. In embodiments, the detectablemoiety is connected to the compound through a covalent linker. Inembodiments, the detectable moiety is connected to the antibody regionthrough a covalent linker. In embodiments, detectable moiety isconnected to peptidyl moiety through a covalent linker. An “imaging ordetectable moiety” as provided herein is a monovalent compounddetectable by spectroscopic, photochemical, biochemical, immunochemical,chemical, or other physical means. In embodiments, the imaging moiety iscovalently attached to the compound. In embodiments, the imaging moietyis covalently attached to the antibody region. In embodiments, theimaging moiety is covalently attached to the peptidyl moiety. Exemplaryimaging moieties include without limitation ³²P, radionuclides,positron-emitting isotopes, fluorescent dyes, fluorophores, antibodies,bioluminescent molecules, chemoluminescent molecules, photoactivemolecules, metals, electron-dense reagents, enzymes (e.g., as commonlyused in an ELISA), magnetic contrast agents, quantum dots,nanoparticles, biotin, digoxigenin, haptens and proteins or otherentities which can be made detectable, e.g., by incorporating aradiolabel into a peptide or antibody specifically reactive with atarget peptide. Any method known in the art for conjugating an antibodyto the moiety may be employed, e.g., using methods described inHermanson, Bioconjugate Techniques 1996, Academic Press, Inc., SanDiego. Exemplary fluorophores include fluorescein, rhodamine, GFP,coumarin, FITC, AlExa fluor, Cy3, Cy5, BODIPY, and cyanine dyes.Exemplary radionuclides include Fluorine-18, Gallium-68, and Copper-64.Exemplary magnetic contrast agents include gadolinium, iron oxide andiron platinum, and manganese. In embodiments, the imaging moiety is abioluminescent molecule. In embodiments, the imaging moiety is aphotoactive molecule. In embodiments, the imaging moiety is a metal. Inembodiments, the imaging moiety is a nanoparticle.

A wide variety of CAR have been described in the scientific literature.In general CARs include an extracellular antigen-binding domain (often ascFv derived from variable heavy and light chains of an antibody), aspacer domain, a transmembrane domain and an intracellular signalingdomain. The intracellular signaling domain usually includes theendodomain of a T cell co-stimulatory molecule (e.g., CD28, 4-1BB orOX-40) and the intracellular domain of CD3ζ.

A “transmembrane domain” as provided herein refers to a polypeptideforming part of a biological membrane. The transmembrane domain providedherein is capable of spanning a biological membrane (e.g., a cellularmembrane) from one side of the membrane through to the other side of themembrane. In embodiments, the transmembrane domain spans from theintracellular side to the extracellular side of a cellular membrane.Transmembrane domains may include non-polar, hydrophobic residues, whichanchor the proteins provided herein including embodiments thereof in abiological membrane (e.g., cellular membrane of a T cell). Anytransmembrane domain capable of anchoring the proteins provided hereinincluding embodiments thereof are contemplated. In embodiments, thetransmembrane domain is L-selectin. The term “L-selectin” as providedherein includes any of the recombinant or naturally-occurring forms ofthe L-selectin protein, also known as CD62L, or variants or homologsthereof that maintain L-selectin activity (e.g. within at least 50%,80%, 90%, 95%, 96%, 97%, 98%, 99% or 100% activity compared toL-selectin). In embodiments, the variants or homologs have at least 90%,95%, 96%, 97%, 98%, 99% or 100% amino acid sequence identity across thewhole sequence or a portion of the sequence (e.g. a 50, 100, 150 or 200continuous amino acid portion) compared to a naturally occurringL-selectin polypeptide. In embodiments, L-selectin is the protein asidentified by the NCBI sequence reference GI.262206315, homolog orfunctional fragment thereof. Non-limiting examples of transmembranedomains include the transmembrane domains of CD8, CD4 or CD3-zeta.

In embodiments, the transmembrane domain is a CD28 transmembrane domain.The term “CD28 transmembrane domain” as provided herein includes any ofthe recombinant or naturally-occurring forms of the transmembrane domainof CD28, or variants or homologs thereof that maintain CD28transmembrane domain activity (e.g. within at least 50%, 80%, 90%, 95%,96%, 97%, 98%, 99% or 100% activity compared to the CD28 transmembranedomain). In some aspects, the variants or homologs have at least 90%,95%, 96%, 97%, 98%, 99% or 100% amino acid sequence identity across thewhole sequence or a portion of the sequence (e.g. a 50, 100, 150 or 200continuous amino acid portion) compared to a naturally occurring CD28transmembrane domain polypeptide. In embodiments, the CD28 transmembranedomain is the protein as identified by SEQ ID NO:22, SEQ ID NO:2,homolog or functional fragment thereof. In embodiments, CD28 is theprotein as identified by the NCBI sequence reference GI:340545506,homolog or functional fragment thereof.

In embodiments, the transmembrane domain is the protein identified bySEQ ID NO:1, SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO:4, SEQ ID NO:5, SEQ IDNO:6, SEQ ID NO:7, SEQ ID NO:8, SEQ ID NO:9, SEQ ID NO:10, homolog orfunctional fragment thereof.

A variety of transmembrane domains can be used the methods providedherein. Table 1 and Table 3 include examples of suitable transmembranedomains. Where a spacer region is present, the transmembrane domain islocated carboxy terminal to the spacer region.

In embodiments, the recombinant CAR protein provided herein includes anintracellular T-cell signaling domain. In embodiments, the intracellularT-cell signaling domain is a CD3 (intracellular T-cell signaling domain.An “intracellular T-cell signaling domain” as provided herein includesamino acid sequences capable of providing primary signaling in responseto binding of an antigen to the antibody region provided hereinincluding embodiments thereof. In embodiments, the signaling of theintracellular T-cell signaling domain results in activation of the Tcell expressing the same. In embodiments, the signaling of theintracellular T-cell signaling domain results in proliferation (celldivision) of the T cell expressing the same. In embodiments, thesignaling of the intracellular T-cell signaling domain resultsexpression by said T cell of proteins known in the art to characteristicof activated T cell (e.g., CTLA-4, PD-1, CD28, CD69). In embodiments,the intracellular T-cell signaling domain includes the signaling domainof the zeta chain of the human CD3 complex. In embodiments, theintracellular T-cell signaling domain is a CD3 (intracellular T-cellsignaling domain. In embodiments, the intracellular T-cell signalingdomain is SEQ ID NO:11.

In embodiments, the recombinant CAR protein provided herein includes anintracellular co-stimulatory signaling domain. An “intracellularco-stimulatory signaling domain” as provided herein includes amino acidsequences capable of providing co-stimulatory signaling in response tobinding of an antigen to the antibody region provided herein includingembodiments thereof. In embodiments, the signaling of the co-stimulatorysignaling domain results in production of cytokines and proliferation ofthe T cell expressing the same. In embodiments, the intracellularco-stimulatory signaling domain is a CD28 intracellular co-stimulatorysignaling domain, a 4-1BB intracellular co-stimulatory signaling domain,a ICOS intracellular co-stimulatory signaling domain, or an OX-40intracellular co-stimulatory signaling domain. In embodiments, theintracellular co-stimulatory signaling domain includes a CD28intracellular co-stimulatory signaling domain, a 4-1BB intracellularco-stimulatory signaling domain, a ICOS intracellular co-stimulatorysignaling domain, an OX-40 intracellular co-stimulatory signaling domainor any combination thereof. Exemplary intracellular co-stimulatorysignaling domains including sequences and accession numbers are listedin Table 2. In embodiments, the intracellular co-stimulatory signalingdomain includes the protein identified by SEQ ID NO:12, SEQ ID NO:13,SEQ ID NO:14, SEQ ID NO:15 or SEQ ID NO:16. In embodiments, theintracellular co-stimulatory signaling domain is SEQ ID NO:12, SEQ IDNO:13, SEQ ID NO:14, SEQ ID NO:15 or SEQ ID NO:16.

In embodiments, the recombinant CAR protein provided herein includes alinker domain. In embodiments, the linker domain is between thetransmembrane domain and the intracellular T-cell signaling domain. Inembodiments, the linker domain is between the intracellular T-cellsignaling domain and the intracellular co-stimulatory signaling domain.In embodiments, the linker domain includes the sequence GGCGG or GGG.

In embodiments, the recombinant CAR protein provided herein includes aspacer region. In embodiments, the spacer region is between thetransmembrane domain and the antibody region. A “spacer region” asprovided herein is a polypeptide connecting the antibody region with thetransmembrane domain. In embodiments, the spacer region connects theheavy chain constant region with the transmembrane domain. Inembodiments, the binding affinity of the antibody region to an antigenis increased compared to the absence of the spacer region. Inembodiments, the steric hindrance between an antibody region and anantigen is decreased in the presence of the spacer region.

In embodiments, the spacer region includes an Fc region. Examples ofspacer regions contemplated for the compositions and methods providedherein include without limitation, immunoglobulin molecules or fragmentsthereof (e.g., IgG1, IgG2, IgG3, IgG4) and immunoglobulin molecules orfragments thereof (e.g., IgG1, IgG2, IgG3, IgG4) including mutationsaffecting Fc receptor binding. In embodiments, the spacer region is afragment of an IgG (e.g., IgG4), wherein said fragment includes adeletion of the CH2 domain. The spacer region may be a peptide linker.In embodiments, the spacer region is a serine-glycine linker. Inembodiments, the spacer region has the sequence GGSG. In embodiments,the spacer region has the sequence GSGSGSGS. In embodiments, the spacerregion is at least 4 amino acids in length. In embodiments, the spacerregion is about 4 amino acids in length. In embodiments, the spacerregion is between 4 and 250 amino acids in length. The spacer region mayinclude residues capable of extending the half-life in vivo (e.g.,plasma) of the proteins provided herein. In embodiments, the spacerregion is 10 amino acids in length. In embodiments, the spacer region is229 amino acids in length. In embodiments, the spacer region isGGGSSGGGSG. The spacer region may be “pasylated.” The term “pasylated”or “pasylation” is used in its customary sense and refers to an aminoacid sequences, which due to their high content in proline, alanine andserine form highly soluble biological polymers. Thus, in embodiments,the spacer region includes about 200 proline, alanine and serineresidues combined. In embodiments, the spacer region includes from about10 to about 200 proline, alanine and serine residues combined. Inembodiments, the spacer region includes hydrophilic residues. Inembodiments, the recombinant CAR protein does not include a spacerregion. In embodiments, the nucleic acid does not include a spacersequence encoding a spacer region. In embodiments, the nucleic acid doesnot include a spacer sequence encoding a spacer region as described inWO 2015105522 A1.

The CAR described herein can include a spacer region located between thecancer antigen targeting domain (e.g., a CD19 ScFv, e.g., the scFvportion can include the CD19 targeted scFv sequence of a CD19-targetedCAR such as that described in Wang et al. 2016 Blood 127:2980-2990) andthe transmembrane domain. A variety of different spacer regions can beused. Some of them include at least portion of a human Fc region, forexample a hinge portion of a human Fc region or a CH3 domain or variantsthereof. Table 4 below provides various spacers that can be used in theCARs described herein.

Some spacer regions include all or part of an immunoglobulin (e.g.,IgG1, IgG2, IgG3, IgG4) hinge region, i.e., the sequence that fallsbetween the CH1 and CH2 domains of an immunoglobulin, e.g., an IgG4 Fchinge or a CD8 hinge. Some spacer regions include an immunoglobulin CH3domain or both a CH3 domain and a CH2 domain. The immunoglobulin derivedsequences can include one ore more amino acid modifications, forexample, 1, 2, 3, 4 or 5 substitutions, e.g., substitutions that reduceoff-target binding.

The spacer region can also comprise a IgG4 hinge region having thesequence ESKYGPPCPSCP (SEQ ID NO:102) or ESKYGPPCPPCP (SEQ ID NO:101).

The spacer region can also comprise the sequence ESKYGPPCPPCP (SEQ IDNO:101) followed by the linker sequence GGGSSGGGSG (SEQ ID NO:100)followed by IgG4 CH3 sequenceGQPREPQVYTLPPSQEEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQEGNVFSCSVMHEALHNHYTQKSLSLSLGK (SEQ ID NO:110). Thus,the entire spacer region can comprise the sequence:ESKYGPPCPPCPGGGSSGGGSGGQPREPQVYTLPPSQEEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQEGNVFSCSVMHEALHNHYTQKS LSLSLGK(SEQ ID NO: 107). In some cases, the spacer has 1, 2, 3, 4 or 5 singleamino acid changes (e.g., conservative changes) compared to those shownin Table 4. In some cases, the IgG4 Fc hinge/linker region that ismutated at two positions (L235E; N297Q) in a manner that reduces bindingby Fc receptors (FcRs).

In embodiments, the nucleic acid encoding the recombinant CAR proteinincludes (i) a heavy chain sequence encoding a heavy chain domain of theprotein, the heavy chain domain includes a variable heavy chain domainand the transmembrane domain; and (ii) a light chain sequence encoding alight chain domain of the protein, the light chain domain includes avariable light chain domain, wherein the variable heavy chain domain andthe variable light chain domain together form at least a portion of theantibody region.

In embodiments, the isolated nucleic acid encoding the recombinant CARprotein encodes from the 5′ end to 3′ end: a light chain sequence, aheavy chain sequence, a transmembrane sequence and an intracellularco-stimulatory signaling sequence. In embodiments, the isolated nucleicacid encodes from the 5′ end to 3′ end: a heavy chain sequence, atransmembrane sequence, an intracellular co-stimulatory signalingsequence and a light chain sequence. In embodiments, the isolatednucleic acid encoding the recombinant CAR protein encodes from the 5′end to 3′ end: a light chain sequence, a self-cleaving peptidyl linkersequence, a heavy chain sequence, a spacer sequence, a transmembranesequence, an intracellular co-stimulatory signaling sequence and anintracellular T-cell signaling sequence. In embodiments, the isolatednucleic acid encoding the recombinant CAR protein encodes from the 5′end to 3′ end: a heavy chain sequence, a spacer sequence, atransmembrane sequence, an intracellular co-stimulatory signalingsequence, an intracellular T-cell signaling sequence, a self-cleavingpeptidyl linker sequence and a light chain sequence.

A “light chain sequence” as provided herein refers to the nucleic acidsequence encoding for a light chain domain provided herein. A lightchain domain provided herein may include a light chain variable (VL)region and/or a light chain constant region (CL). A “heavy chainsequence” as provided herein refers to the nucleic acid sequenceencoding for a heavy chain domain provided herein. A heavy chain domainprovided herein may include heavy chain variable (VH) region and/or aheavy chain constant region (CH). A “transmembrane sequence” as providedherein refers to the nucleic acid sequence encoding for a transmembranedomain provided herein. An “intracellular T-cell signaling sequence” asprovided herein refers to the nucleic acid sequence encoding for aintracellular T-cell signaling domain provided herein. An “intracellularco-stimulatory signaling sequence” (also referred to herein as acostimulatory domain) as provided herein refers to the nucleic acidsequence encoding for a intracellular co-stimulatory signaling domainprovided herein.

The costimulatory domain can be any domain that is suitable for use witha CD3ζ signaling domain. In some cases, the costimulatory domain is aCD28 costimulatory domain that includes a sequence that is at least 90%,at least 95%, at least 98% identical to or identical to:RSKRSRGGHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRS (SEQ ID NO:121; LL to GG aminoacid change double underlined). In some cases, the CD28 co-signalingdomain has 1, 2, 3, 4 of 5 amino acid changes (preferably conservativeand preferably not in the underlined GG sequence) compared to SEQ IDNO:121. In some cases the co-signaling domain is a 4-1BB co-signalingdomain that includes a sequence that is at least 90%, at least 95%, atleast 98% identical to or identical to:KRGRKKLLYIFKQPFMRPVQTTQEEDGCSCRFPEEEEGGCEL (SEQ ID NO:122). In somecases, the 4-1BB co-signaling domain has 1, 2, 3, 4 of 5 amino acidchanges (preferably conservative) compared to SEQ ID NO:122.

The costimulatory domain(s) are located between the transmembrane domainand the CD3ζ signaling domain. Table 5 includes examples of suitablecostimulatory domains together with the sequence of the CD3ζ signalingdomain.

In various embodiments: the costimulatory domain is selected from thegroup consisting of: a costimulatory domain depicted in Table 5 or avariant thereof having 1-5 (e.g., 1 or 2) amino acid modifications, aCD28 costimulatory domain or a variant thereof having 1-5 (e.g., 1 or 2)amino acid modifications, a 4-1BB costimulatory domain or a variantthereof having 1-5 (e.g., 1 or 2) amino acid modifications and an OX40costimulatory domain or a variant thereof having 1-5 (e.g., 1 or 2)amino acid modifications. In certain embodiments, a 4-1BB costimulatorydomain or a variant thereof having 1-5 (e.g., 1 or 2) amino acidmodifications in present. In some embodiments there are twocostimulatory domains, for example a CD28 co-stimulatory domain or avariant thereof having 1-5 (e.g., 1 or 2) amino acid modifications(e.g., substitutions) and a 4-1BB co-stimulatory domain or a variantthereof having 1-5 (e.g., 1 or 2) amino acid modifications (e.g.,substitutions). In various embodiments the 1-5 (e.g., 1 or 2) amino acidmodification are substitutions. The costimulatory domain is aminoterminal to the CD3ζ signaling domain and in some cases a short linkerconsisting of 2-10, e.g., 3 amino acids (e.g., GGG) is positionedbetween the costimulatory domain and the CD3ζ signaling domain.

CD3ζ Signaling Domain

The CD3ζ Signaling domain can be any domain that is suitable for usewith a CD3ζ signaling domain. In some cases, the CD3ζ signaling domainincludes a sequence that is at least 90%, at least 95%, at least 98%identical to or identical to:RVKFSRSADAPAYQQGQNQLYNELNLGRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKGHDGLYQGLSTATKDTYDALHMQALPPR (SEQ ID NO:119).In some cases, the CD3ζ signaling has 1, 2, 3, 4 of 5 amino acid changes(preferably conservative) compared to SEQ ID NO:119.

Truncated EGFR

The CD3ζ signaling domain can be followed by a ribosomal skip sequence(e.g., LEGGGEGRGSLLTCGDVEENPGPR; SEQ ID NO:124) and a truncated EGFRhaving a sequence that is at least 90%, at least 95%, at least 98%identical to or identical to:

(SEQ ID NO: 125) LVTSLLLCELPHPAFLLIPRKVCNGIGIGEFKDSLSINATNIKHFKNCTSISGDLHILPVAFRGDSFTHTPPLDPQELDILKTVKEITGFLLIQAWPENRTDLHAFENLEIIRGRTKQHGQFSLAVVSLNITSLGLRSLKEISDGDVIISGNKNLCYANTINWKKLFGTSGQKTKIISNRGENSCKATGQVCHALCSPEGCWGPEPRDCVSCRNVSRGRECVDKCNLLEGEPREFVENSECIQCHPECLPQAMNITCTGRGPDNCIQCAHYIDGPHCVKTCPAGVMGENNTLVWKYADAGHVCHLCHPNCTYGCTGPGLEGCPTNGPKIPSIATGMVGALLLL LVVALGIGLFM.In some cases, the truncated EGFR has 1, 2, 3, 4 of 5 amino acid changes(preferably conservative) compared to SEQ ID NO:125.

In embodiments, the isolated nucleic acid encoding the recombinant CARprotein includes a self-cleaving peptidyl sequence encoding aself-cleaving peptidyl domain between the heavy chain sequence and thelight chain sequence. In embodiments, the self-cleaving peptidyl linkersequence is a T2A sequence. In embodiments, the self-cleaving peptidyllinker sequence is a T2A sequence or a 2A sequence. In embodiments, theself-cleaving peptidyl linker sequence is a foot-and-mouth disease virussequence. In embodiments, the self-cleaving peptidyl linker sequence isPVKQLLNFDLLKLAGDVESNPGP (SEQ ID NO:83). In embodiments, theself-cleaving peptidyl linker sequence is an equine rhinitis A virussequence. In embodiments, the self-cleaving peptidyl linker sequence isQCTNYALLKLAGDVESNPGP (SEQ ID NO:84). In embodiments, the self-cleavingpeptidyl linker sequence is a porcine teschovirus 1 sequence. Inembodiments, the self-cleaving peptidyl linker sequence isATNFSLLKQAGDVEENPGP (SEQ ID NO:85). In embodiments, the self-cleavingpeptidyl linker sequence is Thosea asigna virus sequence. Inembodiments, the self-cleaving peptidyl linker sequence isEGRGSLLTCGDVESNPGP (SEQ ID NO:86). In embodiments, the light chainsequence is 3′ to the heavy chain sequence. In embodiments, the lightchain sequence is 5′ to the heavy chain sequence.

In embodiments, the antibody region is a cetuximab meditope enableddomain, trastuzumab meditope enabled domain, pertuzumab meditope enableddomain, M5A meditope enabled domain or rituximab meditope enableddomain. In embodiments, the antibody region is a humanized cetuximabmeditope enabled domain. In embodiments, the antibody region is ahumanized rituximab meditope enabled domain.

In another aspect, an isolated nucleic acid is provided. The isolatednucleic acid encodes a recombinant CAR protein including a first portionincluding an antibody heavy chain variable domain and a second portionincluding an antibody light chain variable domain and an antibody lightchain constant domain, wherein the first portion further includes atransmembrane domain. In embodiments, the recombinant CAR protein is theprotein identified by SEQ ID NO:17. In embodiments, the recombinant CARprotein is the protein identified by SEQ ID NO:28.

In embodiments, the recombinant CAR protein includes from the N-terminusto the C-terminus: a signaling peptide of SEQ ID NO:18, a heavy chaindomain of SEQ ID NO:19, a hinge region of SEQ ID NO:20, a spacer regionof SEQ ID NO:21, a transmembrane domain of SEQ ID NO:22, anintracellular co-stimulatory signaling domain of SEQ ID NO:23, a linkerdomain of SEQ ID NO:24, an intracellular T-cell signaling domain of SEQID NO:25, a first self-cleaving peptidyl linker domain of SEQ ID NO:26,a marker peptide of SEQ ID NO:29, a second self-cleaving peptidyl linkerdomain of SEQ ID NO:30, a signaling peptide of SEQ ID NO:18 and a lightchain domain of SEQ ID NO:27. In embodiments, the recombinant CARprotein includes from the N-terminus to the C-terminus: a signalingpeptide of SEQ ID NO:18, a heavy chain domain of SEQ ID NO:19, a hingeregion of SEQ ID NO:20, a spacer region of SEQ ID NO:21, a transmembranedomain of SEQ ID NO:22, an intracellular co-stimulatory signaling domainof SEQ ID NO:23, a linker domain of SEQ ID NO:24, an intracellularT-cell signaling domain of SEQ ID NO:25, a first self-cleaving peptidyllinker domain of SEQ ID NO:26, a marker peptide of SEQ ID NO:29, asecond self-cleaving peptidyl linker domain of SEQ ID NO:30, a signalingpeptide of SEQ ID NO:18 or a light chain domain of SEQ ID NO:27. Inembodiments, the recombinant CAR protein includes from the N-terminus tothe C-terminus: a signaling peptide of SEQ ID NO:18, a heavy chaindomain of SEQ ID NO:19, a hinge region of SEQ ID NO:20, a spacer regionof SEQ ID NO:21, a transmembrane domain of SEQ ID NO:22, anintracellular co-stimulatory signaling domain of SEQ ID NO:23, a linkerdomain of SEQ ID NO:24, an intracellular T-cell signaling domain of SEQID NO:25, a self-cleaving peptidyl linker domain of SEQ ID NO:26, asignaling peptide of SEQ ID NO:18 and a light chain domain of SEQ IDNO:27. In embodiments, the recombinant CAR protein includes from theN-terminus to the C-terminus: a signaling peptide of SEQ ID NO:18, aheavy chain domain of SEQ ID NO:19, a hinge region of SEQ ID NO:20, aspacer region of SEQ ID NO:21, a transmembrane domain of SEQ ID NO:22,an intracellular co-stimulatory signaling domain of SEQ ID NO:23, alinker domain of SEQ ID NO:24, an intracellular T-cell signaling domainof SEQ ID NO:25, a self-cleaving peptidyl linker domain of SEQ ID NO:26,a signaling peptide of SEQ ID NO:18 or a light chain domain of SEQ IDNO:27.

The term “signaling peptide” as referred to herein is used according toits ordinary meaning in the art and refers to a peptide having a lengthof about 5-30 amino acids. A signaling peptide is present at theN-terminus of newly synthesized proteins that form part of the secretorypathway. Proteins of the secretory pathway include, but are not limitedto proteins that reside either inside certain organelles (theendoplasmic reticulum, Golgi or endosomes), are secreted from the cell,or are inserted into a cellular membrane. In embodiments, the signalingpeptide forms part of the transmembrane domain of a protein.

The term “heavy chain domain” as referred to herein is used according toits ordinary meaning in the art and refers to a polypeptide including aheavy chain variable (VH) region and a heavy chain constant region (CH).The term “light chain domain” as referred to herein is used according toits ordinary meaning in the art and refers to a polypeptide including alight chain variable (VL) region and a light chain constant region (CL).

In embodiments, the protein includes from the N-terminus to theC-terminus: a signaling peptide of SEQ ID NO:126, a light chain domainof SEQ ID NO:127, a self-cleaving peptidyl linker domain of SEQ IDNO:128, a heavy chain domain of SEQ ID NO:129, a hinge region of SEQ IDNO:130, a first spacer region of SEQ ID NO:131, a second spacer regionof SEQ ID NO:132, a transmembrane domain of SEQ ID NO:133, anintracellular co-stimulatory signaling domain of SEQ ID NO:134, a linkerdomain of SEQ ID NO: 135, and an intracellular T-cell signaling domainof SEQ ID NO:136. In embodiments, the protein includes from theN-terminus to the C-terminus: a signaling peptide of SEQ ID NO:126, alight chain domain of SEQ ID NO:127, a self-cleaving peptidyl linkerdomain of SEQ ID NO:128, a heavy chain domain of SEQ ID NO:129, a hingeregion of SEQ ID NO:130, a first spacer region of SEQ ID NO:131, asecond spacer region of SEQ ID NO:132, a transmembrane domain of SEQ IDNO:133, an intracellular co-stimulatory signaling domain of SEQ IDNO:134, a linker domain of SEQ ID NO:135, or an intracellular T-cellsignaling domain of SEQ ID NO:136.

In embodiments, the recombinant CAR protein includes from the N-terminusto the C-terminus: a signaling peptide of SEQ ID NO:137, a heavy chaindomain of SEQ ID NO:138, a hinge region of SEQ ID NO:138, a first spacerregion of SEQ ID NO:140, a second spacer region of SEQ ID NO:141, atransmembrane domain of SEQ ID NO:142, an intracellular co-stimulatorysignaling domain of SEQ ID NO:143, a linker domain of SEQ ID NO:144, andan intracellular T-cell signaling domain of SEQ ID NO:145, aself-cleaving peptidyl linker domain of SEQ ID NO:146, and a light chaindomain of SEQ ID NO:147. In embodiments, the recombinant CAR proteinincludes from the N-terminus to the C-terminus: a signaling peptide ofSEQ ID NO:137, a heavy chain domain of SEQ ID NO:138, a hinge region ofSEQ ID NO:139, a first spacer region of SEQ ID NO:140, a second spacerregion of SEQ ID NO:141, a transmembrane domain of SEQ ID NO:142, anintracellular co-stimulatory signaling domain of SEQ ID NO:143, a linkerdomain of SEQ ID NO:144, and an intracellular T-cell signaling domain ofSEQ ID NO:145, a self-cleaving peptidyl linker domain of SEQ ID NO:146,or a light chain domain of SEQ ID NO:147.

In embodiments, the first portion further includes an intracellularT-cell signaling domain. In embodiments, the intracellular T-cellsignaling domain is SEQ ID NO:11. In embodiments, the intracellularT-cell signaling domain is a CD3 (intracellular T-cell signaling domain.In embodiments, the first portion includes an intracellularco-stimulatory signaling domain. In embodiments, the intracellularco-stimulatory signaling domain is a CD28 intracellular co-stimulatorysignaling domain, a 4-1BB intracellular co-stimulatory signaling domain,a ICOS intracellular co-stimulatory signaling domain, or an OX-40intracellular co-stimulatory signaling domain. In embodiments, theintracellular co-stimulatory signaling domain is SEQ ID NO:12, SEQ IDNO:13, SEQ ID NO:14, SEQ ID NO:15 or SEQ ID NO:16.

In embodiments, the first portion includes a linker domain. Inembodiments, the linker domain is between the transmembrane domain andthe intracellular T-cell signaling domain. In embodiments, the linkerdomain is between the intracellular T-cell signaling domain and theintracellular co-stimulatory signaling domain. In embodiments, thelinker domain comprises the sequence GGCGG or GGG.

In embodiments, the first portion includes a CD3 (intracellular T-cellsignaling domain and intracellular co-stimulatory signaling domain. Inembodiments, the first portion includes from the amino terminus to thecarboxy terminus: the heavy chain variable domain, a heavy chainconstant domain, the transmembrane domain, the CD3 (intracellular T-cellsignaling domain and an intracellular co-stimulatory signaling domain.

In embodiments, the isolated nucleic acid encoding the recombinant CARmolecule provided herein includes a spacer region positioned between theheavy chain variable domain and the transmembrane domain. Inembodiments, the spacer region includes a hinge region. In embodiments,the hinge region is a CD8 hinge region. In embodiments, the hinge regionis a CD28 hinge region. A “spacer region” as provided herein is apolypeptide connecting the antibody heavy chain variable domain with thetransmembrane domain. Where the first portion of the recombinant CARprotein provided herein including embodiments thereof, includes a heavychain constant domain, the heavy chain constant domain connects theheavy chain variable domain with the spacer region and the spacer regionconnects the heavy chain constant domain with the transmembrane domain.Thus in embodiments, the spacer region connects the heavy chain variabledomain with the transmembrane domain. In embodiments, the spacer regionconnects the heavy chain constant domain with the transmembrane domain.

In embodiments, the antibody heavy chain variable domain and theantibody light chain variable domain are humanized. In embodiments, thefirst portion includes a heavy chain constant domain. In embodiments,the isolated nucleic acid includes a self-cleaving peptidyl sequencebetween the first portion and the second portion. In embodiments, theself-cleaving peptidyl encoding sequence is a T2A encoding sequence or a2A encoding sequence. In embodiments, the self-cleaving peptidylencoding sequence is a T2A encoding sequence or 2A encoding sequence. Inembodiments, the nucleic acid sequence encoding the second portion is 3′to the nucleic acid sequence encoding the first portion.

In embodiments, the recombinant CAR protein or antibody region providedherein including embodiments thereof competes for antigen binding with,specifically binds to the same antigen or epitope as, and/or containsone, more, or all CDRs (or CDRs comprising at least at or about 75, 80,85, 90, 91, 92, 93, 94, 95, 96, 97, 98, or 99% identity to the CDRs),e.g., including a heavy chain CDR 1, 2, and/or 3 and/or a light chainCDR1, 2, and/or 3, of one or more known antibodies, including anycommercially available antibody, such as abagovomab, abciximab,adalimumab, adecatumumab, alemtuzumab, altumomab, altumomab pentetate,anatumomab, anatumomab mafenatox, arcitumomab, atlizumab, basiliximab,bectumomab, ectumomab, belimumab, benralizumab, bevacizumab,brentuximab, canakinumab, capromab, capromab pendetide, catumaxomab,certolizumab, clivatuzumab tetraxetan, daclizumab, denosumab,eculizumab, edrecolomab, efalizumab, etaracizumab, ertumaxomab,fanolesomab, Fbta05, fontolizumab, gemtuzumab, girentuximab, golimumab,ibritumomab, igovomab, infliximab, ipilimumab, labetuzumab, mepolizumab,muromonab, muromonab-CD3, natalizumab, necitumumab, nimotuzumab,ofatumumab, omalizumab, oregovomab, palivizumab, panitumumab,ranibizumab, rituximab, satumomab, sulesomab, ibritumomab, ibritumomabtiuxetan, tocilizumab, tositumomab, trastuzumab, Trbs07, ustekinumab,visilizumab, votumumab, zalutumumab, and/or brodalumab; and/oranrukinzumab, bapineuzumab, dalotuzumab, demcizumab, ganitumab,inotuzumab, mavrilimumab, moxetumomab pasudotox, rilotumumab,sifalimumab, tanezumab, tralokinumab, tremelimumab, urelumab, theantibody produced by the hybridoma 10B5 (see Edelson & Unanue, Curr OpinImmunol, 2000 August; 12(4):425-31), B6H12.2 (abcam) or other anti-CD47antibody (see Chao et al., Cell, 142, 699-713, Sep. 3, 2010).

In embodiments, the recombinant CAR protein or antibody regionspecifically binds to an antigen selected from the group consisting of:CA-125, glycoprotein (GP) IIb/IIIa receptor, TNF-alpha, CD52, TAG-72,Carcinoembryonic antigen (CEA), interleukin-6 receptor (IL-6R), IL-2,interleukin-2 receptor a-chain (CD25), CD22, B-cell activating factor,interleukin-5 receptor (CD125), VEGF, VEGF-A, CD30, IL-1beta, prostatespecific membrane antigen (PSMA), CD3, EpCAM, EGF receptor (EGFR), MUC1,human interleukin-2 receptor, Tac, RANK ligand, a complement protein,e.g., C5, EpCAM, CD11a, e.g., human CD11a, an integrin, e.g., alpha-vbeta-3 integrin, vitronectin receptor alpha v beta 3 integrin, HER2,neu, CD3, CD15, CD20 (small and/or large loops), Interferon gamma, CD33,CA-IX, TNF alpha, CTLA-4, carcinoembryonic antigen, IL-5, CD3 epsilon,CAM, Alpha-4-integrin, IgE, e.g., IgE Fc region, an RSV antigen, e.g., Fprotein of respiratory syncytial virus (RSV), TAG-72, NCA-90(granulocyte cell antigen), IL-6, GD2, GD3, IL-12, IL-23, IL-17,CTAA16.88, IL13, interleukin-1 beta, beta-amyloid, IGF-1 receptor(IGF-1R), delta-like ligand 4 (DLL4), alpha subunit of granulocytemacrophage colony stimulating factor receptor, hepatocyte growth factor,IFN-alpha, nerve growth factor, IL-13, CD326, Programmed cell death 1ligand 1 (PD-L1, a.k.a. CD274, B7-H1), CD47, and CD137.

In embodiments, the recombinant CAR protein or antibody region is ananti-CD19 protein, anti-CD20 protein, anti-CD22 protein, anti-CD30protein, anti-CD33 protein, anti-CD44v6/7/8 protein, anti-CD123 protein,anti-CEA protein, anti-EGP-2 protein, anti-EGP-40 protein, anti-erb-B2protein, anti-erb-B2,3,4 protein, anti-FBP protein, anti-fetalacetylcholine receptor protein, anti-GD2 protein, anti-GD3 protein,anti-Her2/neu protein, anti-IL-13R-a2 protein, anti-KDR protein, antik-light chain protein, anti-LeY protein, anti-L1 cell adhesion moleculeprotein, anti-MAGE-A1 protein, anti-mesothelin protein, anti-murine CMVinfected cell protein, anti-MUC2 protein, anti-NKGD2 protein, anti,oncofetal antigen protein, anti-PCSA protein, anti-PSMA protein,anti-TAA (targeted by mAb IfE) protein, anti-EGFR protein, anti-TAG-72protein or anti-VEGF-72 protein.

In embodiments, the recombinant CAR protein or antibody region has alight chain sequence including P8, V9 or 19, 110 or L10, Q38, R39, T40,N41 G42, S43, P44, R45, D82, 183, A84, D85, Y86, Y87, G99, A100, G101,T102, K103, L104, E105, R142, S162, V163, T164, E165, Q166, D167, S168,and/or Y173, according to Kabat numbering, and/or has a heavy chainhaving Q6, P9, R38, Q39, S40, P41, G42, K43, G44, L45, S84, D86, T87,A88, 189, Y90, Y91, W103, G104, Q105, G106, T107, L108, V111, T110,Y147, E150, P151, V152, T173, F174, P175, A176, V177, Y185, S186, and/orL187, according to Kabat numbering.

Also provided are complexes including an antibody region or proteinbound to one or more compounds including a peptidyl moiety as providedherein. The antibody region or protein may be any of the antibodiesdescribed herein including fragments thereof. The one or more compoundsincluding a peptidyl moiety as provided herein may include any one ormore of the compounds described herein, such as those described in thissection, including monovalent and multivalent compounds, and labeledcompounds.

In another aspect, an expression vector including a nucleic acidprovided herein (encoding the recombinant CAR protein and/or the T cellreceptor specific for a viral antigen) including embodiments thereof isprovided. In embodiments, the expression vector is a viral vector. Inembodiments, the virus is a lentivirus or onco-retrovirus. Inembodiments, the virus is a lentivirus or onco-retrovirus.

In another aspect, a mammalian cell including the expression vectorencoding the recombinant CAR protein and/or the T cell receptor specificfor a viral antigen provided herein including embodiments thereof isprovided. In embodiments, the mammalian cell is a natural killer (Nk)cell. In embodiments, the mammalian cell is an induced pluripotent stemcell. In embodiments, the mammalian cell is a hematopoietic stem cell.In embodiments, the mammalian cell includes a recombinant CAR proteinwherein the recombinant CAR protein includes a first polypeptide and asecond polypeptide, the first polypeptide including a heavy chainvariable domain, a heavy chain constant domain, a transmembrane domain,a CD3 (signaling domain and a co-stimulatory T-cell signaling domain,the second polypeptide including a light chain variable domain and alight chain constant domain.

In another aspect, a T lymphocyte including the expression vectorprovided herein including embodiments thereof is provided. Inembodiments, the T lymphocyte includes a recombinant CAR protein whereinthe recombinant CAR protein includes a first polypeptide and a secondpolypeptide, the first polypeptide including a heavy chain variabledomain, a heavy chain constant domain, a transmembrane domain, a CD3(signaling domain and a co-stimulatory T-cell signaling domain, thesecond polypeptide including a light chain variable domain and a lightchain constant domain.

Recombinant CAR Proteins

The T cells provided herein express a T cell receptor specific for aviral antigen (e.g., CMV antigen) and a recombinant CAR protein whichexhibits novel diagnostic capabilities and allows to rapidly addfunctionality to adoptive immunotherapy. The recombinant proteins (i.e.recombinant CAR proteins) provided herein are useful, inter alia, for abroad variety of therapeutic and diagnostic purposes. For example, therecombinant proteins provided herein including embodiments thereof maybe used as non-invasive means to characterize chimeric antigen receptor(CAR) T cells before and/or during treatment of diseases (e.g., cancer).By adding functionality to the CAR immunoreceptors a population ofpatients with antigen-positive tumors can be efficiently treated andmonitored irrespective of their HLA genotype. Adoptive immunotherapyusing T lymphocytes that express these functionally improvedtumor-specific CARs can be a powerful therapeutic strategy for thetreatment of cancer and other diseases (e.g., infectious diseases (e.g.,HIV infection)). Further, using the recombinant proteins provided hereinincluding embodiments thereof allow for testing and improvement of thefunctionality and safety of CAR T cells.

In another aspect, a recombinant CAR protein is provided. Therecombinant CAR protein includes (i) an antibody region including acentral cavity formed by a heavy chain variable (VH) region and a lightchain variable (VL) region, wherein the central cavity forms a peptidebinding site including framework region amino acid residues; and (ii) atransmembrane domain. In embodiments, the antibody region furtherincludes a heavy chain constant region (CH) and a light chain constantregion (CL). In embodiments, the antibody region includes an Fc domain.In embodiments, the antibody region is a humanized antibody region (e.g.a humanized mouse antibody region). In embodiments, the antibody regiondoes not include a scFv antibody region.

In embodiments, the recombinant CAR protein further includes anintracellular T-cell signaling domain as described herein. Inembodiments, the intracellular T-cell signaling domain is a CD3 ζintracellular T-cell signaling domain. In embodiments, the recombinantCAR protein further includes an intracellular co-stimulatory signalingdomain. In embodiments, the intracellular co-stimulatory signalingdomain is a CD28 intracellular co-stimulatory signaling domain, a 4-1BBintracellular co-stimulatory signaling domain, a ICOS intracellularco-stimulatory signaling domain, or an OX-40 intracellularco-stimulatory signaling domain.

In embodiments, the recombinant CAR protein further includes a spacerregion. In embodiments, the spacer region is between the transmembranedomain and the antibody region.

In embodiments, the recombinant CAR protein further includes a linkerdomain. In embodiments, the linker domain is between the transmembranedomain and the intracellular T-cell signaling domain. In embodiments,the linker domain is between the intracellular T-cell signaling domainand the intracellular co-stimulatory signaling domain. In embodiments,the linker domain includes the sequence GGCGG or GGG. In embodiments,the antibody region is a cetuximab meditope enabled domain, trasuzumabmeditope enabled domain, pertuzumab meditope enabled domain, M5Ameditope enabled domain or rituximab meditope enabled domain. Inembodiments, a compound including an peptidyl moiety is bound to thepeptide binding site. In embodiments, the compound is a multivalentmeditope. A “multivalent meditope” as provided herein is a peptidylmoiety as described herein. Thus, a multivalent meditope is capable ofbinding the peptide binding site provided herein including embodimentsthereof. In embodiments, the multivalent meditope binds to the FR liningthe peptide binding site. In embodiments, the multivalent meditope isbound to therapeutic or diagnostic moiety through a chemical linker. Inembodiments, the multivalent meditope has the structure of formula (I)or (II). The proteins and compounds may be any of the protein orcompounds described herein including embodiments thereof.

In another aspect, a recombinant CAR protein is provided. Therecombinant CAR protein includes a first portion including an antibodyheavy chain variable domain and a second portion including an antibodylight chain variable domain and an antibody light chain constant domain,wherein the first portion further includes a transmembrane domain, andwherein the antibody heavy chain variable domain, the antibody lightchain variable domain and the antibody light chain constant domaintogether form an antibody region.

In another aspect, a mammalian cell including the T Cell receptorspecific for a viral antigen and a recombinant CAR protein providedherein including embodiments thereof is provided, wherein thetransmembrane domain is within the cell membrane of the mammalian cell.In embodiments, the mammalian cell is a natural killer (Nk) cell. Inembodiments, the mammalian cell is an induced pluripotent stem cell. Inembodiments, the mammalian cell is a hematopoietic stem cell.

In another aspect, a T lymphocyte including T Cell receptor specific fora viral antigen and the recombinant CAR protein provided hereinincluding embodiments thereof is provided, wherein the transmembranedomain is within the cell membrane of the T lymphocyte.

CMV Triplex Vaccine Compositions and Uses

Described herein is the use of a viral vaccine (e.g. cytomegalovirus(CMV) Triplex Vaccine) in combination with engineered T cells that bothrecognize a viral antigen (e.g. CMV antigen) and express a recombinantCAR protein able to target an antigen expressed, for example, on normalB cells as well as on cancerous cells (CMV/meCAR T cells) to treat avariety of cancers. The term “CAR T cell” or “CAR T cells” as providedherein refers to a T cell expressing a recombinant CAR protein asdescribed herein. The methods entail administering CMV/CAR T cells whichrecognize a tumor antigen (e.g., CD19) in addition to a CMV antigen to apatient. Subsequent to administration of the CMV/CAR T cells, a CMVTriplex Vaccine is administered to the patient. The vaccine can promoteproliferation of the CMV/CAR T cells and enhance their anti-tumoractivity. Thus, the methods can improve T cell resistance and provide ameans by which to re-stimulate CAR T cells after relapse. In addition,the methods can provide more reliable engraftment and persistence in alow target-antigen setting (e.g., post-myeloablative HCT) withre-expansion of CAR T cells by CMV vaccine administration. The methodsdescribed herein also permit in vivo expansion of CMV-specific CAR Tcells, instead of or in addition to ex vivo expansion, avoidingexcessive T cell exhaustion that results in some cases from ex vivomanufacturing.

The CMV/CAR T cells can be prepared by a method comprising: (a)providing PBMC from a cytomegalovirus (CMV)-seropositive human donor;(b) exposing the PBMC to at least one CMV antigen (e.g., pp65 or amixture of IE1/IE2 overlapping peptides); (c) treating the exposed cellsto produce a population of cells enriched for stimulated cells specificfor CMV (e.g., treating them to create a population of cells that isenriched for stimulated cells specific for CMV relative to the untreatedpopulation of cells); (d) transducing at least a portion of the enrichedpopulation of cells with a vector (e.g., a lentiviral vector) expressinga CAR, thereby preparing T cells specific for CMV and expressing a CAR.In some cases, a CMV vaccine, for example, the CMV Triplex Vaccine, canbe administered to the donor prior to harvest of the PBMC in order toincrease the frequency of CMV-seropositive T cells.

The CMV Triplex Vaccine is a recombinant MVA expressing a fusion proteinof two CMV antigens, IE1-exon4 and IE2-exon5 and CMV antigen pp65. Thesequence encoding the fusion protein is inserted in the MVA deletion-IIlocus and the sequence encoding the CMV pp65 antigen is inserted intothe MVA deletion-III locus. The CMV Triplex Vaccine is described ingreater detail in U.S. Pat. No. 8,580,276, hereby incorporated byreference.

The methods described herein include: a method for treating a patientcomprising: (a) providing a composition comprising a population of Tcells expressing both a chimeric antigen receptor (CAR) and a T cellreceptor specific for a cytomegalovirus (CMV) antigen; (b) administeringthe composition to the patient; and (c) administering to the patient aviral vector encoding: (i) CMV pp65 and (ii) a fusion protein comprisingexon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2 (e5) eitherprior to or subsequent to administering the composition comprising apopulation of T cells to the patient.

Described herein is a method for treating a patient comprising: (a)providing a composition comprising a population of T cells expressingboth a chimeric antigen receptor (CAR) and a T cell receptor specificfor a cytomegalovirus (CMV) antigen; (b) administering the compositionto the patient; and (c) administering to the patient a viral vectorencoding: (i) CMV pp65 and (ii) a fusion protein comprising exon 4 ofCMV protein IE1 (e4) and exon 5 of CMV protein IE2 (e5) either prior toor subsequent to administering the composition comprising a populationof T cells to the patient.

In various embodiments: the step of administering a viral vector to thepatient comprises administering recombinant MVA virus; expression of (i)CMV pp65 and (ii) the fusion protein comprising exon 4 of CMV proteinIE1 (e4) and exon 5 of CMV protein IE2 (e5) is under the control of mH5promoter; the patient is immunocompromised; the patient isimmunocompetent; the patient is CMV-seronegative prior to treatment; thepatient is CMV-seropositive prior to treatment; the patient receivedhematopoietic stem cells (HSC) from a CMV-seropositive orCMV-seronegative donor prior to administering the comprising apopulation of T cells expressing both a chimeric antigen receptor (CAR)and a T cell receptor specific for a cytomegalovirus (CMV) antigen; andthe CAR is targeted to CD19; administration of the viral vector occursat least 5 days after treatment with the composition comprising apopulation of T cells; the viral vector is administered to the patientboth prior to and subsequent to the administration of the compositioncomprising a population of T cells; the viral vector is administered tothe hematopoietic stem cell donor prior to harvesting the stem cells;the viral vector is administered to the patient only prior to theadministration of the composition comprising a population of T cells;the viral vector is administered to the patient only subsequent to theadministration of the composition comprising a population of T cells;the viral vector is administered to the patient at least four times; thepatient is suffering from non-Hodgkin's Lymphoma.

The CAR is selective can be selective for any antigen, for example:CD19, CS1, CD123, 5T4, 8H9, αvβ6 integrin, alphafetoprotein (AFP),B7-H6, CA-125 carbonic anhydrase 9 (CA9), CD19, CD20, CD22, CD30, CD33,CD38, CD44, CD44v6, CD44v7/8, CD52, CD123, CD171, carcionoembryonicantigen (CEA), EGFrvIII, epithelial glycoprotein-2 (EGP-2), epithelialglycoprotein-40 (EGP-40), ErbB1/EGFR, ErbB2/HER2/neu/EGFR2, ErbB3,ErbB4, epithelial tumor antigen (ETA), FBP, fetal acetylcholine receptor(AchR), folate receptor-α, G250/CAIX, ganglioside 2 (GD2), ganglioside 3(GD3), HLA-A1, HLA-A2, high molecular weight melanoma-associated antigen(HMW-MAA), IL-13 receptor a2, KDR, k-light chain, Lewis Y (LeY), L1 celladhesion molecule, melanoma-associated antigen (MAGE-A1), mesothelin,Murine CMV infected cella, mucin-1 (MUC1), mucin-16 (MUC16), naturalkiller group 2 member D (NKG2D) ligands, nerve cell adhesion molecule(NCAM), NY-ESO-1, Oncofetal antigen (h5T4), prostate stem cell antigen(PSCA), prostate-specific membrane antigen (PSMA), receptor-tyrosinekinase-like orphan receptor 1 (ROR1), TAA targeted by mAb IgE,tumor-associated glycoprotein-72 (TAG-72), tyrosinase, and vascularendothelial growth factor (VEGF) receptors.

In certain embodiments: the CAR is selective for an antigen selectedfrom: CD19, CD123, CS1, BCMA, CD44v6, CD33, CD22, IL-13α2, PSA, HER-2,EGFRv3, CEA, and C7R; the CAR comprises: a scFv selective for theselected non-CMV antigen; a hinge/linker region; a transmembrane domain;a co-signaling domain; and CD3 ζ signaling domain; the co-signalingdomain is selected from a CD28 co-signaling domain and a 4-IBBco-signaling domain; transmembrane domain is selected from a CD28transmembrane domain and a CD4 transmembrane domain.

In various embodiments of the treatment method: the population of humanT cells is autologous to the patient; the population of human T cells isallogeneic to the patient; the method reduces the risk of CMV infection;the method reduces CMV viremia and/or disease; the patient wasCMV-immune prior to treatment and the method reduces the risk of CMVinfection; the patient was not CMV-immune prior to treatment and themethod reduces CMV viremia or disease.

In some embodiments, the step of providing a population of T cellsexpressing a CAR and a T cell receptor specific for a CMV antigencomprises: (a) providing PBMC or a T cell subpopulation from aCMV-seropositive human donor; (b) exposing the PBMC or the T cellsubpopulation to at least one CMV antigen; (c) treating the exposedcells to produce a population of cells enriched for stimulated cellsspecific for CMV; (d) transducing at least a portion of the enrichedpopulation of cells with a vector expressing a CAR. In some embodiments,the step of treating the exposed cells to produce a population of cellsenriched for stimulated cells specific for CMV comprises treating thestimulated cells to produce a population of cells enriched for cellsexpressing an activation marker.

In some embodiments, the step of providing a population of T cellexpressing a CAR and a T cell receptor specific for a CMV antigencomprises: (a) administering a viral vector encoding: (i) CMV pp65 and(ii) a fusion protein comprising exon 4 of CMV protein IE1 (e4) and exon5 of CMV protein IE2 (e5) to a human donor to convert a CMV-seronegativehuman donor to one containing T cells responsive to CMV antigens pp65,IE1 and IE2; (b) obtaining PBMC from the CMV-seropositive human donor;(c) exposing the PBMC to at least one CMV antigen; (d) treating theexposed cells to produce a population of cells enriched for stimulatedcells specific for CMV; (e) transducing at least a portion of theenriched population of cells with a vector expressing a CAR, therebyproviding a population of T cell expressing a CAR and a T cell receptorspecific for a CMV antigen.

In some embodiments, the step of providing a population of T cellexpressing a CAR and a T cell receptor specific for a CMV antigencomprises: (a) administering a viral vector encoding: (i) CMV pp65 and(ii) a fusion protein comprising exon 4 of CMV protein IE1 (e4) and exon5 of CMV protein IE2 (e5) to a CMV-seropositive human donor; (b)obtaining PBMC from the CMV-seropositive human donor; (b) exposing thePBMC to at least one CMV antigen; (c) treating the exposed cells toproduce a population of cells enriched for stimulated cells specific forCMV; (d) transducing at least a portion of the enriched population ofcells with a vector expressing a CAR, thereby providing a population ofT cell expressing a CAR and a T cell receptor specific for a CMVantigen.

In the case of patients who have received HSC transplant, in someembodiments, the viral vector is administered to the patient or thehematopoietic stem cell transplant donor at least twice subsequent tothe administration of the composition comprising a population of Tcells, the hematopoietic stem cells were autologous to the patient; andthe hematopoietic stem cells were allogenic to the patient.

Also described is a method for preparing T cells expressing a CAR and aT cell receptor specific for a CMV antigen, the method comprising: (a))administering a viral vector encoding: (i) CMV pp65 and (ii) a fusionprotein comprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMVprotein IE2 (e5) to a CMV-seropositive human donor; (b) obtaining PBMCfrom the CMV-seropositive human donor; (b) exposing the PBMC to at leastone CMV antigen; (c) treating the exposed cells to produce a populationof cells enriched for stimulated cells specific for CMV; (d) transducingat least a portion of the enriched population of cells with a vectorexpressing a CAR, thereby providing a population of T cell expressing aCAR and a T cell receptor specific for a CMV antigen.

Also described is a method for preparing T cells expressing a CAR and aT cell receptor specific for a CMV antigen, the method comprising: a))administering a viral vector encoding: (i) CMV pp65 and (ii) a fusionprotein comprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMVprotein IE2 (e5) to a CMV-seropositive human donor; (b) obtaining PBMCfrom the CMV-seropositive human donor; (b) exposing the PBMC to at leastone CMV antigen; (c) treating the exposed cells to produce a populationof cells enriched for stimulated cells specific for CMV; (d) transducingat least a portion of the enriched population of cells with a vectorexpressing a CAR, thereby providing a population of T cell expressing aCAR and a T cell receptor specific for a CMV antigen.

In various embodiments of the of the methods for producing T cells, themethod further comprises expanding the population of T cell expressing aCAR and a T cell receptor specific for a CMV antigen.

In various embodiments of the of the methods for producing T cells: theactivation marker is IFN-γ or other activation marker such as CD137,CD107 or other cytokines; the CMV antigen is pp65 protein or anantigenic portion thereof, the CMV antigen comprises two or moredifferent antigenic CMV pp65 peptides; the step of transducing theenriched population of cells does not comprise CD3 stimulation; the stepof transducing the enriched population of cells does not comprise CD28stimulation; the step of transducing the enriched population of cellsdoes not comprise CD28 stimulation or CD3 stimulation; the step oftransducing the enriched population of cells does not comprise exposingthe cells to an anti-CD28 antibody or an anti-CD3 antibody; the enrichedpopulation of cells is at least 40% IFN-γ positive, at least 20% CD8positive, and at least 20% CD4 positive; the enriched population ofcells are cultured for fewer than 10 days prior to the step oftransducing the enriched population of cells with a vector encoding aCAR; the method further comprises expanding the CMV specific T cellsexpressing a CAR cells by exposing them to an antigen that binds to theCAR; the step of expanding the CMV-specific T cells expressing a CARcomprises exposing the cells to T cells expressing the antigen thatbinds the CAR; and the expansion takes place is the presence of at leastone exogenously added interleukin.

In some cases, the method includes a step of preparing T cells specificfor cytomegalovirus (CMV) and expressing a chimeric antigen receptor(CAR), the method comprising: (a) providing T cells (e.g., PBMC) from acytomegalovirus CMV seropositive human donor; (b) exposing the PBMC toat least one CMV antigen; (c) treating the exposed cells to produce apopulation of cells enriched for stimulated cells specific for CMV; (d)transducing at least a portion of the enriched population of cells witha vector expressing a CAR, thereby preparing T cells specific for CMVand expressing a CAR. In various cases: the step of treating the exposedcells (e.g., using a selection step) to produce a population of cellsenriched for stimulated cells specific for CMV comprises treating thestimulated cells to produce a population of cells enriched for cellsexpressing an activation marker (e.g., IFN-γ of IL-13); the PBMC arecultured for less than 5 days (less than 4, 3, 2, 1 days) prior toexposure to the CMV antigen; the cells are exposed to the CMV antigenfor fewer than 3 days (fewer than 48 hrs, 36 hrs, 24 hrs) the CMVantigen is pp65 protein or an antigenic portion thereof, the CMV antigencomprises two or more different antigenic CMV pp65 peptides; the step oftransducing the enriched population of cells does not comprise CD3stimulation; the step of transducing the enriched population of cellsdoes not comprise CD28 stimulation; the step of transducing the enrichedpopulation of cells does not comprise CD3 stimulation or CD28stimulation; the enriched population of cells is at least 40% (e.g.,50%, 60%, 70%) IFN-γ positive, at least 20% (e.g., 25%, 30%, 35%) CD8positive, and at least 20% (e.g., 25%, 30%, 35%) CD4 positive; theenriched population of cells are cultured for fewer than 10 (fewer than9, 8, 7, 5, 3, 2) days prior to the step of transducing the enrichedpopulation of cells with a vector encoding a CAR. In some cases, the Tcells are from a CMV positive donor and are exposed to a CMV antigensuch as CMV pp65 or a mixture of CMV protein peptides (for example 10-20amino acid peptides that are fragments of pp65) in the presence of IL-2to create a population of stimulated cells. In some cases, thepopulation of stimulated cells is treated to prepare a population ofcells that express IFN-γ. In some cases, the CMV/CAR T cells do notrecognize an antigen from a second virus. For example, they do notrecognize an Epstein-Barr virus antigen or an influenza virus antigen oran Adenovirus antigen.

In some cases, the method further comprises expanding the CMV specific Tcells expressing a CAR (CMV/CAR T cells) by exposing them an antigenthat binds to the CAR.

In some cases, the CMV/CAR T cells are not expanded ex vivo by exposureto an antigen that binds the CAR, by a CMV antigen or by exposure toexogenously added cytokines.

In some cases, the step of expanding the CMV-specific T cells expressinga CAR comprises exposing the cells to T cells expressing the antigenthat bind the CAR (e.g., the expansion takes place is the presence of atleast one exogenously added interleukin (e.g., one or both of IL-1 andIL-15) and a T cell expressing the antigen recognized by the CAR.

In various cases, the CAR is selective for an antigen selected from:CD19, CS1, CD123, 5T4, 8H9, αvβ6 integrin, alphafetoprotein (AFP),B7-H6, CA-125 carbonic anhydrase 9 (CA9), CD19, CD20, CD22, CD30, CD33,CD38, CD44, CD44v6, CD44v7/8, CD52, CD123, CD171, carcionoembryonicantigen (CEA), EGFrvIII, epithelial glycoprotein-2 (EGP-2), epithelialglycoprotein-40 (EGP-40), ErbB1/EGFR, ErbB2/HER2/neu/EGFR2, ErbB3,ErbB4, epithelial tumor antigen (ETA), FBP, fetal acetylcholine receptor(AchR), folate receptor-α, G250/CAIX, ganglioside 2 (GD2), ganglioside 3(GD3), HLA-A1, HLA-A2, high molecular weight melanoma-associated antigen(HMW-MAA), IL-13 receptor a2, KDR, k-light chain, Lewis Y (LeY), L1 celladhesion molecule, melanoma-associated antigen (MAGE-A1), mesothelin,Murine CMV infected cella, mucin-1 (MUC1), mucin-16 (MUC16), naturalkiller group 2 member D (NKG2D) ligands, nerve cell adhesion molecule(NCAM), NY-ESO-1, Oncofetal antigen (h5T4), prostate stem cell antigen(PSCA), prostate-specific membrane antigen (PSMA), receptor-tyrosinekinase-like orphan receptor 1 (ROR1), TAA targeted by mAb IgE,tumor-associated glycoprotein-72 (TAG-72), tyrosinase, and vascularendothelial growth factor (VEGF) receptors.

In some cases, the CAR is selective for an antigen selected from: CD19,CD123, CS1, BCMA, CD44v6, CD33, CD22, IL-13α2, PSA, HER2, EGFRv3, CEA,and C7R.

In some cases, the CAR comprises: a scFv selective for the selectednon-CMV antigen; a hinge/linker region; a transmembrane domain; aco-signaling domain; and CD3 (signaling domain; the chimeric antigenreceptor further comprises a spacer sequence located between theco-signaling domain and the CD3ζ signaling domain; the co-signalingdomain is selected from a CD28 co-signaling domain and a 4-IBBco-signaling domain; the transmembrane domain is selected from a CD28transmembrane domain and a CD4 transmembrane domain; the vectorexpressing the CAR expresses a truncated human EGFR from the sametranscript encoding the CAR, wherein the truncated human EGFR lacks aEGF ligand binding domain and lacks a cytoplasmic signaling domain; thespacer sequence comprises or consists of 3-10 consecutive Gly; thehinge/linker region comprises at least 10 amino acids of an IgG constantregion or hinge region; the IgG is IgG4; the hinge/linger regioncomprises an IgG4 CD3 domain; the hinge/linger region comprises an IgG4Fc domain or a variant thereof; the hinge/linker region comprises orconsists of 4-12 amino acids; and hinge/linker region is selected fromthe group consisting of: the sequence ESKYGPPCPPCPGGGSSGGGSG and thesequence GGGSSGGGSG.

In some cases, the CMV/CAR T cell population is a population in which atleast 20% of the cells in the population are CD4+, in which at least 20%of the cells in the population are CD8+, or in which at least 60% of thecells in the population are IFNγ+.

In various cases: the T cells are specific for CMV pp65; and the CARbinds an antigen selected from: CD19, CD123, CS1, BCMA, CD44v6, CD33,CD22, IL-13α2, PSA, HER2, EGFRv3, CEA, and C7R.

Also described is a method of treating a patient suffering from cancercomprising administering a composition comprising CMV/CAR T cellsfollowed by administration of CMV Triplex Vaccine. In various cases: thepopulation of human T cells are autologous to the patient; thepopulation of human T cells are allogenic to the patient; the populationof human T cells are autologous to the patient; the method furthercomprises administering to the patient at least two or at least threedoses of a CMV Triplex Vaccine.

Described below are T cells specific for CMV and CD19. These CMV/CAR Tcells were generated using a rapid and efficient method for generatingand selecting CMV-specific T cells. The method, which employs IFNγcapture of CMV-specific T cells, consistently and efficiently enrichedCMV-specific T cells while preserving the broad spectrum of CMVrepertoires. Moreover, the cells remained amenable to gene modificationafter a brief CMVpp65 stimulation, avoiding the need for CD3/CD28 beadactivation prior to transduction. This is significant because CD3/CD28activation can cause activation-induced cell death (AICD) ofCMV-specific T cells. Engineering the bulk IFNγ-captured T cells with aCD19CAR lentivirus followed by stimulation with CD19 antigen resulted in50 to 70% of the CAR⁺ T cells responding to pp65 stimulation,representing the subset of functional CMV/CAR T cells. The CMV/CAR Tcells exhibited specific cytolytic activity and secreted IFNγ, as wellas proliferating vigorously after engagement of endogenous CMVpp65 Tcell receptors or engineered CD19 CARs. Upon transfer into tumor bearingmice, the CMV/CAR T cells mediated cytokine released syndrome (CRS),which has been found to correlate with anti-tumor efficacy in theclinic.

While the CMV/CAR T cells described herein express a CAR targeted toCD19, the same methods can be used to generate CMV CAR T cells targetedto any desired antigen.

Efficient in vivo activation of virus-specific T cells through the TCRdemands that viral antigens are processed and presented in a humanleukocyte antigen (HLA)-dependent manner. This can be achieved byadministering CMV Triplex Vaccine to the patient subsequent toadministration of the CMV/CAR T cells.

The antitumor activity of CMV/CAR T cells can be enhanced as aconsequence of proliferation following CMV peptide vaccination. Thissuggests that the cell dose of CMV/CAR T cells could be significantlydecreased as compared to conventional CAR T cells, due to theirpotential to proliferate in vivo in response to vaccine, avoidingprolonged culture times and the risk of terminal differentiation.

In some cases, such as in the CMV/CAR T cells targeted to CD19 describedherein, the CMV/CAR T cells also express a truncated EGFR (EGFRt). Cellsexpressing EGFRt can be killed by administration of an antibody, such acetuximab, targeted to EGFR. This permits control and reduction ofpotential on/off-target toxicity.

The administration of CMV Triplex Vaccine subsequent to treatment withCMV/CD19 CAR T cells can augment the antitumor activity of adoptivelytransferred CMV/CD19 CAR T cells in several scenarios: 1) to salvagepatients not achieving complete remission or relapsing after CAR T celltherapy, 2) vaccine boost when CD19 CAR T cells are failing to persistregardless of tumor responses at that time, 3) planned vaccination ondays post-administration CD19 CAR T cells. There is also potentialbenefit of using the CMV/CAR T cells pre-emptively post-allogeneic HCT,both to eliminate minimal residual disease (MRD) and control CMV,potentially preventing reactivation of virus or undergoing expansion inresponse to latent CMV re-activation.

Moreover, administration of CMV Triplex Vaccine has the potential toprofoundly impact the general field of adoptive T cell therapy, since bytransducing a variety of tumor-directed CARs into CMV-specific T cells,it is possible to tailor this strategy to a wide range of malignanciesand tumor targets.

Triplex Vaccine

CMV Triplex Vaccine is a recombinant MVA that expresses three CMVantigens, i.e., at least a portion or Immediate-Early Gene-1 (IE1), atleast a portion of Immediate-Early Gene-2 (IE2) and at least a portionof pp65. The IE1 antigen and the IE2 antigen can be expressed a fusionprotein, for example, a protein encoded by the nucleotide sequence ofSEQ ID NO:99. Expression of the CMV antigens can be under the control ofa modified H5 (mH5) promoter. A CMV Triplex Vaccine is fully describedin U.S. Pat. No. 8,580,276 and in Wang et al. (Vaccine 28:1547, 2010)

The CMV Triplex Vaccine can express CMV pp65 and a CMV IE fusion protein(IEfusion). The IEfusion can include an antigenic portion of IE1 (e.g.,Exon 4) and an antigenic portion of 1E2 (e.g., Exon 5), wherein theantigenic portions elicit an immune response when expressed by avaccine. In one aspect, the IEfusion is has the sequence encoded by SEQID NO:99 or another nucleotide sequence that encodes the same amino acidsequence as SEQ ID NO:99.

As explained in U.S. Pat. No. 8,580,276, the CMV Triplex Vaccineincludes three of the best recognized antigens in the CD8 subset: pp65,IE1, and IE2. There is no region of homology greater than 5 amino acidsbetween the major exons of both proteins. Individually, both antigensare recognized broadly by almost 70% of the general population(Sylwester et al. 2005). The divergent sequence of both IE1/e4 andIE2/e5 used here predicts an entirely different subset of HLA bindingpeptides using publicly available Class I and II motif algorithms(Peters and Sette 2007). Human subjects that were evaluated forrecognition of both IE1 and IE2 antigens were found in many instances torecognize one or the other but not both. Among the research subjectsanalyzed, 24% recognized IE2 with or without pp65 to the exclusion ofIE1. This result strongly suggests that the recognition elements forboth antigens are unique, and by including both of them in the vaccine,the breadth of individuals with disparate HLA types that will recognizeand develop an immune response to the vaccine is extended. The fusion ofmajor exons from both antigens achieves the dual goal of reducing thenumber of separate inserts and eliminating the need for a third insertpromoter. The advantages of this approach include placement of allvaccine antigens in one vector, and diminishing the dose of virus neededto attain sufficient immunity simultaneously against all of the includedantigens.

Also as explained in U.S. Pat. No. 8,580,276, prior to conductingexperiments with rMVA in clinical samples, the capacity for stimulationof both CD4+ and CD8+ T cells was assessed using the commerciallyavailable pp65 and IE1 library and a newly designed IE2 peptide library.Relationships among the T cell populations were similar to priorresults: pp65 promotes a substantial CD4 and CD8 response in over 70% ofparticipants, while IE1 and IE2 are recognized less frequently andmainly in the CD8+ T cell compartment. MVA expressing the IEfusionantigen with or without the pp65 antigen was evaluated in PBMC fromhealthy volunteers to establish their recognition properties using afully human system. The results showed that the memory T cell expansionstimulated by the rMVA for both the IEfusion and pp65 antigens, followedthe proportions found ex vivo for the same volunteers using the peptidelibrary approach. While there was substantial amplification of therelevant T cell populations, the stimulation did not skew the populationtowards a particular subset or antigen specificity. The data alsoconfirms that the IEfusion protein is processed and presentedappropriately to stimulate existing T cell populations in a manner thatmaintains the phenotypic distribution as expected in the ex vivoanalysis. The most rigorous evaluation of the processing of the rMVA forT cell response is using PBMC from transplant patients. PBMC from HCTrecipients in all three risk categories were evaluated and anequivalently strong recognition of both rMVAs was found. In some cases,it was even more vigorous than in the PBMC of healthy adults. Nointerference with the recognition of the IE antigen by the co-expressedpp65 antigen was found from the same rMVA, which further confirms thatthe recognition of both antigens can take place at the same time andderived from the same vector.

Any of the vaccine compositions disclosed in U.S. Pat. Nos. 7,163,685,8,580,276 and 9,675,689 as well as in US published applicationUS20170246292 A1 may be used for the methods and compositions providedherein and are hereby incorporated by reference in their entirety andfor all purposes.

In one embodiment, the nucleic acid sequence encoding vaccinia mH5promoter has a sequence containing nucleotides 3075-3168 of SEQ ID NO:97or 3022-3133 of SEQ ID NO:98.

Pharmaceutical Compositions

Pharmaceutical compositions include compositions wherein the activeingredient (e.g. compositions described herein, including embodiments orexamples) is contained in a therapeutically effective amount, i.e., inan amount effective to achieve its intended purpose. The actual amounteffective for a particular application will depend, inter alia, on thecondition being treated. In an aspect, the pharmaceutical compositionincludes a population of T cells, wherein the T cells includes (e.g.expresses) the recombinant CAR protein and the T cell receptor specificfor a viral antigen as described herein, optionally in combination witha pharmaceutical acceptable excipient. When administered in methods totreat a disease, the compostions including a population of T cellsdescribed herein will be provided in an effective to achieve the desiredresult, e.g., modulating the activity of a target molecule, and/orreducing, eliminating, or slowing the progression of disease symptoms.Determination of a therapeutically effective amount of a compound of theinvention is well within the capabilities of those skilled in the art,especially in light of the detailed disclosure herein.

The dosage and frequency (single or multiple doses) administered to amammal can vary depending upon a variety of factors, for example,whether the mammal suffers from another disease, and its route ofadministration; size, age, sex, health, body weight, body mass index,and diet of the recipient; nature and extent of symptoms of the diseasebeing treated (e.g. symptoms of cancer and severity of such symptoms),kind of concurrent treatment, complications from the disease beingtreated or other health-related problems. Other therapeutic regimens oragents can be used in conjunction with the methods and compounds of theinvention. Adjustment and manipulation of established dosages (e.g.,frequency and duration) are well within the ability of those skilled inthe art.

For any composition (e.g., recombinant protein, nucleic acid) providedherein, the therapeutically effective amount can be initially determinedfrom cell culture assays. Target concentrations will be thoseconcentrations of active compound(s) that are capable of achieving themethods described herein, as measured using the methods described hereinor known in the art. As is well known in the art, effective amounts foruse in humans can also be determined from animal models. For example, adose for humans can be formulated to achieve a concentration that hasbeen found to be effective in animals. The dosage in humans can beadjusted by monitoring effectiveness and adjusting the dosage upwards ordownwards, as described above. Adjusting the dose to achieve maximalefficacy in humans based on the methods described above and othermethods is well within the capabilities of the ordinarily skilledartisan.

Dosages may be varied depending upon the requirements of the patient andthe compound being employed. The dose administered to a patient, in thecontext of the present invention should be sufficient to affect abeneficial therapeutic response in the patient over time. The size ofthe dose also will be determined by the existence, nature, and extent ofany adverse side-effects. Determination of the proper dosage for aparticular situation is within the skill of the practitioner. Generally,treatment is initiated with smaller dosages which are less than theoptimum dose of the compound. Thereafter, the dosage is increased bysmall increments until the optimum effect under circumstances isreached.

Dosage amounts and intervals can be adjusted individually to providelevels of the administered compound effective for the particularclinical indication being treated. This will provide a therapeuticregimen that is commensurate with the severity of the individual'sdisease state.

Utilizing the teachings provided herein, an effective prophylactic ortherapeutic treatment regimen can be planned that does not causesubstantial toxicity and yet is effective to treat the clinical symptomsdemonstrated by the particular patient. This planning should involve thecareful choice of active compound by considering factors such ascompound potency, relative bioavailability, patient body weight,presence and severity of adverse side effects, preferred

“Pharmaceutically acceptable excipient” and “pharmaceutically acceptablecarrier” refer to a substance that aids the administration of an activeagent to and absorption by a subject and can be included in thecompositions of the present invention without causing a significantadverse toxicological effect on the patient. Non-limiting examples ofpharmaceutically acceptable excipients include water, NaCl, normalsaline solutions, lactated Ringer's, normal sucrose, normal glucose,binders, fillers, disintegrants, lubricants, coatings, sweeteners,flavors, salt solutions (such as Ringer's solution), alcohols, oils,gelatins, carbohydrates such as lactose, amylose or starch, fatty acidesters, hydroxymethycellulose, polyvinyl pyrrolidine, and colors, andthe like. Such preparations can be sterilized and, if desired, mixedwith auxiliary agents such as lubricants, preservatives, stabilizers,wetting agents, emulsifiers, salts for influencing osmotic pressure,buffers, coloring, and/or aromatic substances and the like that do notdeleteriously react with the compounds of the invention. One of skill inthe art will recognize that other pharmaceutical excipients are usefulin the present invention.

The term “pharmaceutically acceptable salt” refers to salts derived froma variety of organic and inorganic counter ions well known in the artand include, by way of example only, sodium, potassium, calcium,magnesium, ammonium, tetraalkylammonium, and the like; and when themolecule contains a basic functionality, salts of organic or inorganicacids, such as hydrochloride, hydrobromide, tartrate, mesylate, acetate,maleate, oxalate and the like.

The term “preparation” is intended to include the formulation of theactive compound with encapsulating material as a carrier providing acapsule in which the active component with or without other carriers, issurrounded by a carrier, which is thus in association with it.Similarly, cachets and lozenges are included. Tablets, powders,capsules, pills, cachets, and lozenges can be used as solid dosage formssuitable for oral administration.

The pharmaceutical preparation is optionally in unit dosage form. Insuch form the preparation is subdivided into unit doses containingappropriate quantities of the active component. The unit dosage form canbe a packaged preparation, the package containing discrete quantities ofpreparation, such as packeted tablets, capsules, and powders in vials orampoules. Also, the unit dosage form can be a capsule, tablet, cachet,or lozenge itself, or it can be the appropriate number of any of thesein packaged form. The unit dosage form can be of a frozen dispersion.

Methods of Treatment

In another aspect, a method of treating cancer is provided. The methodincludes administering to a subject in need thereof an effective amountof the mammalian cell (e.g. T cells) provided herein includingembodiments thereof, wherein the antibody region is an anti-cancerantibody region.

In another aspect, a method of treating cancer is provided. The methodincludes administering to a subject in need thereof an effective amountof the T-lymphocyte provided herein including embodiments thereof,wherein the antibody region is an anti-cancer antibody region. Inembodiments, the T-lymphocyte is an autologous T-lymphocyte. Inembodiments, the T-lymphocyte is a heterologous T-lymphocyte. Inembodiments, the cancer is a solid tumor cancer or hematologicmalignancy. In embodiments, the cancer is ovarian cancer, renal cellcarcinoma, a B-cell malignancy, leukemia, lymphoma, breast cancer,colorectal cancer, prostate cancer, neuroblastoma, melanoma,medulloblastoma, lung cancer, osteosarcoma, glioblastoma or glioma. Inembodiments, the leukemia is acute lymphoid leukemia. In embodiments,the leukemia is chronic lymphocytic leukemia. In embodiments, theleukemia is acute myeloid leukemia. In embodiments, the leukemia ischronic myeloid leukemia.

In another aspect, a method of reprogramming a T lymphocyte is provided.The method includes contacting a T lymphocyte with the expression vectorprovided herein including embodiments thereof.

In another aspect, a method of detecting a cancer is provided. Themethod includes (i) administering to a cancer patient an effectiveamount of a T lymphocyte including the recombinant CAR protein providedherein including embodiments thereof, the T cell receptor specific for aviral antigen provided herein including embodiments thereof andoptionally a compound including a peptidyl moiety capable of binding tothe peptide binding site, wherein the compound further optionallyincludes a detectable label, and wherein the antibody region is ananti-cancer antibody region. The method may include (ii) allowing thecompound to bind to the peptide binding site thereby forming arecombinant protein-compound complex. The method may include (iii)detecting the recombinant protein-compound complex within the cancerpatient thereby detecting the cancer.

As used herein, “treatment” or “treating,” or “palliating” or“ameliorating” are used interchangeably herein. These terms refer to anapproach for obtaining beneficial or desired results including but notlimited to therapeutic benefit and/or a prophylactic benefit. Bytherapeutic benefit is meant eradication or amelioration of theunderlying disorder being treated. Also, a therapeutic benefit isachieved with the eradication or amelioration of one or more of thephysiological symptoms associated with the underlying disorder such thatan improvement is observed in the patient, notwithstanding that thepatient may still be afflicted with the underlying disorder. Forprophylactic benefit, the compositions may be administered to a patientat risk of developing a particular disease, or to a patient reportingone or more of the physiological symptoms of a disease, even though adiagnosis of this disease may not have been made. Treatment includespreventing the disease, that is, causing the clinical symptoms of thedisease not to develop by administration of a protective compositionprior to the induction of the disease; suppressing the disease, that is,causing the clinical symptoms of the disease not to develop byadministration of a protective composition after the inductive event butprior to the clinical appearance or reappearance of the disease;inhibiting the disease, that is, arresting the development of clinicalsymptoms by administration of a protective composition after theirinitial appearance; preventing re-occurring of the disease and/orrelieving the disease, that is, causing the regression of clinicalsymptoms by administration of a protective composition after theirinitial appearance. For example, certain methods herein treat cancer(e.g. lung cancer, ovarian cancer, osteosarcoma, bladder cancer,cervical cancer, liver cancer, kidney cancer, skin cancer (e.g., Merkelcell carcinoma), testicular cancer, leukemia, lymphoma, head and neckcancer, colorectal cancer, prostate cancer, pancreatic cancer, melanoma,breast cancer, neuroblastoma). For example certain methods herein treatcancer by decreasing or reducing or preventing the occurrence, growth,metastasis, or progression of cancer; or treat cancer by decreasing asymptom of cancer. Symptoms of cancer (e.g. lung cancer, ovarian cancer,osteosarcoma, bladder cancer, cervical cancer, liver cancer, kidneycancer, skin cancer (e.g., Merkel cell carcinoma), testicular cancer,leukemia, lymphoma, head and neck cancer, colorectal cancer, prostatecancer, pancreatic cancer, melanoma, breast cancer, neuroblastoma) wouldbe known or may be determined by a person of ordinary skill in the art.

As used herein the terms “treatment,” “treat,” or “treating” refers to amethod of reducing the effects of one or more symptoms of a disease orcondition characterized by expression of the protease or symptom of thedisease or condition characterized by expression of the protease. Thusin the disclosed method, treatment can refer to a 10%, 20%, 30%, 40%,50%, 60%, 70%, 80%, 90%, or 100% reduction in the severity of anestablished disease, condition, or symptom of the disease or condition.For example, a method for treating a disease is considered to be atreatment if there is a 10% reduction in one or more symptoms of thedisease in a subject as compared to a control. Thus the reduction can bea 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, or any percentreduction in between 10% and 100% as compared to native or controllevels. It is understood that treatment does not necessarily refer to acure or complete ablation of the disease, condition, or symptoms of thedisease or condition. Further, as used herein, references to decreasing,reducing, or inhibiting include a change of 10%, 20%, 30%, 40%, 50%,60%, 70%, 80%, 90% or greater as compared to a control level and suchterms can include but do not necessarily include complete elimination.

An “effective amount” is an amount sufficient to accomplish a statedpurpose (e.g. achieve the effect for which it is administered, treat adisease, reduce enzyme activity, reduce one or more symptoms of adisease or condition). An example of an “effective amount” is an amountsufficient to contribute to the treatment, prevention, or reduction of asymptom or symptoms of a disease, which could also be referred to as a“therapeutically effective amount.” A “reduction” of a symptom orsymptoms (and grammatical equivalents of this phrase) means decreasingof the severity or frequency of the symptom(s), or elimination of thesymptom(s). A “prophylactically effective amount” of a drug is an amountof a drug that, when administered to a subject, will have the intendedprophylactic effect, e.g., preventing or delaying the onset (orreoccurrence) of an injury, disease, pathology or condition, or reducingthe likelihood of the onset (or reoccurrence) of an injury, disease,pathology, or condition, or their symptoms. The full prophylactic effectdoes not necessarily occur by administration of one dose, and may occuronly after administration of a series of doses. Thus, a prophylacticallyeffective amount may be administered in one or more administrations. An“activity decreasing amount,” as used herein, refers to an amount ofantagonist required to decrease the activity of an enzyme or proteinrelative to the absence of the antagonist. A “function disruptingamount,” as used herein, refers to the amount of antagonist required todisrupt the function of an enzyme or protein relative to the absence ofthe antagonist. Guidance can be found in the literature for appropriatedosages for given classes of pharmaceutical products. For example, forthe given parameter, an effective amount will show an increase ordecrease of at least 5%, 10%, 15%, 20%, 25%, 40%, 50%, 60%, 75%, 80%,90%, or at least 100%. Efficacy can also be expressed as “-fold”increase or decrease. For example, a therapeutically effective amountcan have at least a 1.2-fold, 1.5-fold, 2-fold, 5-fold, or more effectover a control. The exact amounts will depend on the purpose of thetreatment, and will be ascertainable by one skilled in the art usingknown techniques (see, e.g., Lieberman, Pharmaceutical Dosage Forms(vols. 1-3, 1992); Lloyd, The Art, Science and Technology ofPharmaceutical Compounding (1999); Pickar, Dosage Calculations (1999);and Remington: The Science and Practice of Pharmacy, 20th Edition, 2003,Gennaro, Ed., Lippincott, Williams & Wilkins).

As used herein, the term “administering” means oral administration,administration as a suppository, topical contact, intravenous,intraperitoneal, intramuscular, intralesional, intrathecal, intranasalor subcutaneous administration, or the implantation of a slow-releasedevice, e.g., a mini-osmotic pump, to a subject. Administration is byany route, including parenteral and transmucosal (e.g., buccal,sublingual, palatal, gingival, nasal, vaginal, rectal, or transdermal).Parenteral administration includes, e.g., intravenous, intramuscular,intra-arteriole, intradermal, subcutaneous, intraperitoneal,intraventricular, and intracranial. Other modes of delivery include, butare not limited to, the use of liposomal formulations, intravenousinfusion, transdermal patches, etc. By “co-administer” it is meant thata composition described herein is administered at the same time, justprior to, or just after the administration of one or more additionaltherapies, for example cancer therapies such as chemotherapy, hormonaltherapy, radiotherapy, or immunotherapy. The compounds of the inventioncan be administered alone or can be coadministered to the patient.Coadministration is meant to include simultaneous or sequentialadministration of the compounds individually or in combination (morethan one compound). Thus, the preparations can also be combined, whendesired, with other active substances (e.g. to reduce metabolicdegradation). The compositions of the present invention can be deliveredby transdermally, by a topical route, formulated as applicator sticks,solutions, suspensions, emulsions, gels, creams, ointments, pastes,jellies, paints, powders, and aerosols.

The compositions of the present invention may additionally includecomponents to provide sustained release and/or comfort. Such componentsinclude high molecular weight, anionic mucomimetic polymers, gellingpolysaccharides and finely-divided drug carrier substrates. Thesecomponents are discussed in greater detail in U.S. Pat. Nos. 4,911,920;5,403,841; 5,212,162; and 4,861,760. The entire contents of thesepatents are incorporated herein by reference in their entirety for allpurposes. The compositions of the present invention can also bedelivered as microspheres for slow release in the body. For example,microspheres can be administered via intradermal injection ofdrug-containing microspheres, which slowly release subcutaneously (seeRao, J. Biomater Sci. Polym. Ed. 7:623-645, 1995; as biodegradable andinjectable gel formulations (see, e.g., Gao Pharm. Res. 12:857-863,1995); or, as microspheres for oral administration (see, e.g., Eyles, J.Pharm. Pharmacol. 49:669-674, 1997). In embodiments, the formulations ofthe compositions of the present invention can be delivered by the use ofliposomes which fuse with the cellular membrane or are endocytosed,i.e., by employing receptor ligands attached to the liposome, that bindto surface membrane protein receptors of the cell resulting inendocytosis. By using liposomes, particularly where the liposome surfacecarries receptor ligands specific for target cells, or are otherwisepreferentially directed to a specific organ, one can focus the deliveryof the compositions of the present invention into the target cells invivo. (See, e.g., Al-Muhammed, J. Microencapsul. 13:293-306, 1996;Chonn, Curr. Opin. Biotechnol. 6:698-708, 1995; Ostro, Am. J. Hosp.Pharm. 46:1576-1587, 1989). The compositions of the present inventioncan also be delivered as nanoparticles.

Utilizing the teachings provided herein, an effective prophylactic ortherapeutic treatment regimen can be planned that does not causesubstantial toxicity and yet is effective to treat the clinical symptomsdemonstrated by the particular patient. This planning should involve thecareful choice of active compound by considering factors such ascompound potency, relative bioavailability, patient body weight,presence and severity of adverse side effects, preferred mode ofadministration and the toxicity profile of the selected agent.

“Anti-cancer agent” is used in accordance with its plain ordinarymeaning and refers to a composition (e.g. compound, drug, antagonist,inhibitor, modulator) having antineoplastic properties or the ability toinhibit the growth or proliferation of cells. In embodiments, ananti-cancer agent is a chemotherapeutic. In embodiments, an anti-canceragent is an agent identified herein having utility in methods oftreating cancer. In embodiments, an anti-cancer agent is an agentapproved by the FDA or similar regulatory agency of a country other thanthe USA, for treating cancer.

The compositions described herein can be used in combination with oneanother, with other active agents known to be useful in treating acancer such as anti-cancer agents.

Examples of anti-cancer agents include, but are not limited to, MEK(e.g. MEK1, MEK2, or MEK1 and MEK2) inhibitors (e.g. XL518, CI-1040,PD035901, selumetinib/AZD6244, GSK1120212/trametinib, GDC-0973,ARRY-162, ARRY-300, AZD8330, PD0325901, U0126, PD98059, TAK-733,PD318088, AS703026, BAY 869766), alkylating agents (e.g.,cyclophosphamide, ifosfamide, chlorambucil, busulfan, melphalan,mechlorethamine, uramustine, thiotepa, nitrosoureas, nitrogen mustards(e.g., mechloroethamine, cyclophosphamide, chlorambucil, meiphalan),ethylenimine and methylmelamines (e.g., hexamethlymelamine, thiotepa),alkyl sulfonates (e.g., busulfan), nitrosoureas (e.g., carmustine,lomusitne, semustine, streptozocin), triazenes (decarbazine)),anti-metabolites (e.g., 5-azathioprine, leucovorin, capecitabine,fludarabine, gemcitabine, pemetrexed, raltitrexed, folic acid analog(e.g., methotrexate), or pyrimidine analogs (e.g., fluorouracil,floxouridine, Cytarabine), purine analogs (e.g., mercaptopurine,thioguanine, pentostatin), etc.), plant alkaloids (e.g., vincristine,vinblastine, vinorelbine, vindesine, podophyllotoxin, paclitaxel,docetaxel, etc.), topoisomerase inhibitors (e.g., irinotecan, topotecan,amsacrine, etoposide (VP16), etoposide phosphate, teniposide, etc.),antitumor antibiotics (e.g., doxorubicin, adriamycin, daunorubicin,epirubicin, actinomycin, bleomycin, mitomycin, mitoxantrone, plicamycin,etc.), platinum-based compounds (e.g. cisplatin, oxaloplatin,carboplatin), anthracenedione (e.g., mitoxantrone), substituted urea(e.g., hydroxyurea), methyl hydrazine derivative (e.g., procarbazine),adrenocortical suppressant (e.g., mitotane, aminoglutethimide),epipodophyllotoxins (e.g., etoposide), antibiotics (e.g., daunorubicin,doxorubicin, bleomycin), enzymes (e.g., L-asparaginase), inhibitors ofmitogen-activated protein kinase signaling (e.g. U0126, PD98059,PD184352, PD0325901, ARRY-142886, SB239063, SP600125, BAY 43-9006,wortmannin, or LY294002, Syk inhibitors, mTOR inhibitors, antibodies(e.g., rituxan), gossyphol, genasense, polyphenol E, Chlorofusin, alltrans-retinoic acid (ATRA), bryostatin, tumor necrosis factor-relatedapoptosis-inducing ligand (TRATL), 5-aza-2′-deoxycytidine, all transretinoic acid, doxorubicin, vincristine, etoposide, gemcitabine,imatinib (Gleevec®), geldanamycin,17-N-Allylamino-17-Demethoxygeldanamycin (17-AAG), flavopiridol,LY294002, bortezomib, trastuzumab, BAY 11-7082, PKC412, PD184352,20-epi-1, 25 dihydroxyvitamin D3; 5-ethynyluracil; abiraterone;aclarubicin; acylfulvene; adecypenol; adozelesin; aldesleukin; ALL-TKantagonists; altretamine; ambamustine; amidox; amifostine;aminolevulinic acid; amrubicin; amsacrine; anagrelide; anastrozole;andrographolide; angiogenesis inhibitors; antagonist D; antagonist G;antarelix; anti-dorsalizing morphogenetic protein-1; antiandrogen,prostatic carcinoma; antiestrogen; antineoplaston; antisenseoligonucleotides; aphidicolin glycinate; apoptosis gene modulators;apoptosis regulators; apurinic acid; ara-CDP-DL-PTBA; argininedeaminase; asulacrine; atamestane; atrimustine; axinastatin 1;axinastatin 2; axinastatin 3; azasetron; azatoxin; azatyrosine; baccatinIII derivatives; balanol; batimastat; BCR/ABL antagonists;benzochlorins; benzoylstaurosporine; beta lactam derivatives;beta-alethine; betaclamycin B; betulinic acid; bFGF inhibitor;bicalutamide; bisantrene; bisaziridinylspermine; bisnafide; bistrateneA; bizelesin; breflate; bropirimine; budotitane; buthionine sulfoximine;calcipotriol; calphostin C; camptothecin derivatives; canarypox IL-2;capecitabine; carboxamide-amino-triazole; carboxyamidotriazole; CaRestM3; CARN 700; cartilage derived inhibitor; carzelesin; casein kinaseinhibitors (ICOS); castanospermine; cecropin B; cetrorelix; chlorins;chloroquinoxaline sulfonamide; cicaprost; cis-porphyrin; cladribine;clomifene analogues; clotrimazole; collismycin A; collismycin B;combretastatin A4; combretastatin analogue; conagenin; crambescidin 816;crisnatol; cryptophycin 8; cryptophycin A derivatives; curacin A;cyclopentanthraquinones; cycloplatam; cypemycin; cytarabine ocfosfate;cytolytic factor; cytostatin; dacliximab; decitabine; dehydrodidemnin B;deslorelin; dexamethasone; dexifosfamide; dexrazoxane; dexverapamil;diaziquone; didemnin B; didox; diethylnorspermine;dihydro-5-azacytidine; 9-dioxamycin; diphenyl spiromustine; docosanol;dolasetron; doxifluridine; droloxifene; dronabinol; duocarmycin SA;ebselen; ecomustine; edelfosine; edrecolomab; eflornithine; elemene;emitefur; epirubicin; epristeride; estramustine analogue; estrogenagonists; estrogen antagonists; etanidazole; etoposide phosphate;exemestane; fadrozole; fazarabine; fenretinide; filgrastim; finasteride;flavopiridol; flezelastine; fluasterone; fludarabine; fluorodaunorunicinhydrochloride; forfenimex; formestane; fostriecin; fotemustine;gadolinium texaphyrin; gallium nitrate; galocitabine; ganirelix;gelatinase inhibitors; gemcitabine; glutathione inhibitors; hepsulfam;heregulin; hexamethylene bisacetamide; hypericin; ibandronic acid;idarubicin; idoxifene; idramantone; ilmofosine; ilomastat;imidazoacridones; imiquimod; immunostimulant peptides; insulin-likegrowth factor-1 receptor inhibitor; interferon agonists; interferons;interleukins; iobenguane; iododoxorubicin; ipomeanol, 4-; iroplact;irsogladine; isobengazole; isohomohalicondrin B; itasetron;jasplakinolide; kahalalide F; lamellarin-N triacetate; lanreotide;leinamycin; lenograstim; lentinan sulfate; leptolstatin; letrozole;leukemia inhibiting factor; leukocyte alpha interferon;leuprolide+estrogen+progesterone; leuprorelin; levamisole; liarozole;linear polyamine analogue; lipophilic disaccharide peptide; lipophilicplatinum compounds; lissoclinamide 7; lobaplatin; lombricine;lometrexol; lonidamine; losoxantrone; lovastatin; loxoribine;lurtotecan; lutetium texaphyrin; lysofylline; lytic peptides;maitansine; mannostatin A; marimastat; masoprocol; maspin; matrilysininhibitors; matrix metalloproteinase inhibitors; menogaril; merbarone;meterelin; methioninase; metoclopramide; MIF inhibitor; mifepristone;miltefosine; mirimostim; mismatched double stranded RNA; mitoguazone;mitolactol; mitomycin analogues; mitonafide; mitotoxin fibroblast growthfactor-saporin; mitoxantrone; mofarotene; molgramostim; monoclonalantibody, human chorionic gonadotrophin; monophosphoryl lipidA+myobacterium cell wall sk; mopidamol; multiple drug resistance geneinhibitor; multiple tumor suppressor 1-based therapy; mustard anticanceragent; mycaperoxide B; mycobacterial cell wall extract; myriaporone;N-acetyldinaline; N-substituted benzamides; nafarelin; nagrestip;naloxone+pentazocine; napavin; naphterpin; nartograstim; nedaplatin;nemorubicin; neridronic acid; neutral endopeptidase; nilutamide;nisamycin; nitric oxide modulators; nitroxide antioxidant; nitrullyn;O6-benzylguanine; octreotide; okicenone; oligonucleotides; onapristone;ondansetron; ondansetron; oracin; oral cytokine inducer; ormaplatin;osaterone; oxaliplatin; oxaunomycin; palauamine; palmitoylrhizoxin;pamidronic acid; panaxytriol; panomifene; parabactin; pazelliptine;pegaspargase; peldesine; pentosan polysulfate sodium; pentostatin;pentrozole; perflubron; perfosfamide; perillyl alcohol; phenazinomycin;phenylacetate; phosphatase inhibitors; picibanil; pilocarpinehydrochloride; pirarubicin; piritrexim; placetin A; placetin B;plasminogen activator inhibitor; platinum complex; platinum compounds;platinum-triamine complex; porfimer sodium; porfiromycin; prednisone;propyl bis-acridone; prostaglandin J2; proteasome inhibitors; proteinA-based immune modulator; protein kinase C inhibitor; protein kinase Cinhibitors, microalgal; protein tyrosine phosphatase inhibitors; purinenucleoside phosphorylase inhibitors; purpurins; pyrazoloacridine;pyridoxylated hemoglobin polyoxyethylerie conjugate; raf antagonists;raltitrexed; ramosetron; ras farnesyl protein transferase inhibitors;ras inhibitors; ras-GAP inhibitor; retelliptine demethylated; rhenium Re186 etidronate; rhizoxin; ribozymes; RII retinamide; rogletimide;rohitukine; romurtide; roquinimex; rubiginone B1; ruboxyl; safingol;saintopin; SarCNU; sarcophytol A; sargramostim; Sdi 1 mimetics;semustine; senescence derived inhibitor 1; sense oligonucleotides;signal transduction inhibitors; signal transduction modulators; singlechain antigen-binding protein; sizofuran; sobuzoxane; sodiumborocaptate; sodium phenylacetate; solverol; somatomedin bindingprotein; sonermin; sparfosic acid; spicamycin D; spiromustine;splenopentin; spongistatin 1; squalamine; stem cell inhibitor; stem-celldivision inhibitors; stipiamide; stromelysin inhibitors; sulfinosine;superactive vasoactive intestinal peptide antagonist; suradista;suramin; swainsonine; synthetic glycosaminoglycans; tallimustine;tamoxifen methiodide; tauromustine; tazarotene; tecogalan sodium;tegafur; tellurapyrylium; telomerase inhibitors; temoporfin;temozolomide; teniposide; tetrachlorodecaoxide; tetrazomine;thaliblastine; thiocoraline; thrombopoietin; thrombopoietin mimetic;thymalfasin; thymopoietin receptor agonist; thymotrinan; thyroidstimulating hormone; tin ethyl etiopurpurin; tirapazamine; titanocenebichloride; topsentin; toremifene; totipotent stem cell factor;translation inhibitors; tretinoin; triacetyluridine; triciribine;trimetrexate; triptorelin; tropisetron; turosteride; tyrosine kinaseinhibitors; tyrphostins; UBC inhibitors; ubenimex; urogenitalsinus-derived growth inhibitory factor; urokinase receptor antagonists;vapreotide; variolin B; vector system, erythrocyte gene therapy;velaresol; veramine; verdins; verteporfin; vinorelbine; vinxaltine;vitaxin; vorozole; zanoterone; zeniplatin; zilascorb; zinostatinstimalamer, Adriamycin, Dactinomycin, Bleomycin, Vinblastine, Cisplatin,acivicin; aclarubicin; acodazole hydrochloride; acronine; adozelesin;aldesleukin; altretamine; ambomycin; ametantrone acetate;aminoglutethimide; amsacrine; anastrozole; anthramycin; asparaginase;asperlin; azacitidine; azetepa; azotomycin; batimastat; benzodepa;bicalutamide; bisantrene hydrochloride; bisnafide dimesylate; bizelesin;bleomycin sulfate; brequinar sodium; bropirimine; busulfan;cactinomycin; calusterone; caracemide; carbetimer; carboplatin;carmustine; carubicin hydrochloride; carzelesin; cedefingol;chlorambucil; cirolemycin; cladribine; crisnatol mesylate;cyclophosphamide; cytarabine; dacarbazine; daunorubicin hydrochloride;decitabine; dexormaplatin; dezaguanine; dezaguanine mesylate;diaziquone; doxorubicin; doxorubicin hydrochloride; droloxifene;droloxifene citrate; dromostanolone propionate; duazomycin; edatrexate;eflornithine hydrochloride; elsamitrucin; enloplatin; enpromate;epipropidine; epirubicin hydrochloride; erbulozole; esorubicinhydrochloride; estramustine; estramustine phosphate sodium; etanidazole;etoposide; etoposide phosphate; etoprine; fadrozole hydrochloride;fazarabine; fenretinide; floxuridine; fludarabine phosphate;fluorouracil; fluorocitabine; fosquidone; fostriecin sodium;gemcitabine; gemcitabine hydrochloride; hydroxyurea; idarubicinhydrochloride; ifosfamide; iimofosine; interleukin I1 (includingrecombinant interleukin II, or rlL.sub.2), interferon alfa-2a;interferon alfa-2b; interferon alfa-n1; interferon alfa-n3; interferonbeta-1a; interferon gamma-1b; iproplatin; irinotecan hydrochloride;lanreotide acetate; letrozole; leuprolide acetate; liarozolehydrochloride; lometrexol sodium; lomustine; losoxantrone hydrochloride;masoprocol; maytansine; mechlorethamine hydrochloride; megestrolacetate; melengestrol acetate; melphalan; menogaril; mercaptopurine;methotrexate; methotrexate sodium; metoprine; meturedepa; mitindomide;mitocarcin; mitocromin; mitogillin; mitomalcin; mitomycin; mitosper;mitotane; mitoxantrone hydrochloride; mycophenolic acid; nocodazoie;nogalamycin; ormaplatin; oxisuran; pegaspargase; peliomycin;pentamustine; peplomycin sulfate; perfosfamide; pipobroman; piposulfan;piroxantrone hydrochloride; plicamycin; plomestane; porfimer sodium;porfiromycin; prednimustine; procarbazine hydrochloride; puromycin;puromycin hydrochloride; pyrazofurin; riboprine; rogletimide; safingol;safingol hydrochloride; semustine; simtrazene; sparfosate sodium;sparsomycin; spirogermanium hydrochloride; spiromustine; spiroplatin;streptonigrin; streptozocin; sulofenur; talisomycin; tecogalan sodium;tegafur; teloxantrone hydrochloride; temoporfin; teniposide; teroxirone;testolactone; thiamiprine; thioguanine; thiotepa; tiazofurin;tirapazamine; toremifene citrate; trestolone acetate; triciribinephosphate; trimetrexate; trimetrexate glucuronate; triptorelin;tubulozole hydrochloride; uracil mustard; uredepa; vapreotide;verteporfin; vinblastine sulfate; vincristine sulfate; vindesine;vindesine sulfate; vinepidine sulfate; vinglycinate sulfate;vinleurosine sulfate; vinorelbine tartrate; vinrosidine sulfate;vinzolidine sulfate; vorozole; zeniplatin; zinostatin; zorubicinhydrochloride, agents that arrest cells in the G2-M phases and/ormodulate the formation or stability of microtubules, (e.g. Taxol™ (i.e.paclitaxel), Taxotere™, compounds comprising the taxane skeleton,Erbulozole (i.e. R-55104), Dolastatin 10 (i.e. DLS-10 and NSC-376128),Mivobulin isethionate (i.e. as CI-980), Vincristine, NSC-639829,Discodermolide (i.e. as NVP-XX-A-296), ABT-751 (Abbott, i.e. E-7010),Altorhyrtins (e.g. Altorhyrtin A and Altorhyrtin C), Spongistatins (e.g.Spongistatin 1, Spongistatin 2, Spongistatin 3, Spongistatin 4,Spongistatin 5, Spongistatin 6, Spongistatin 7, Spongistatin 8, andSpongistatin 9), Cemadotin hydrochloride (i.e. LU-103793 andNSC-D-669356), Epothilones (e.g. Epothilone A, Epothilone B, EpothiloneC (i.e. desoxyepothilone A or dEpoA), Epothilone D (i.e. KOS-862, dEpoB,and desoxyepothilone B), Epothilone E, Epothilone F, Epothilone BN-oxide, Epothilone A N-oxide, 16-aza-epothilone B, 21-aminoepothilone B(i.e. BMS-310705), 21-hydroxyepothilone D (i.e. Desoxyepothilone F anddEpoF), 26-fluoroepothilone, Auristatin PE (i.e. NSC-654663), Soblidotin(i.e. TZT-1027), LS-4559-P (Pharmacia, i.e. LS-4577), LS-4578(Pharmacia, i.e. LS-477-P), LS-4477 (Pharmacia), LS-4559 (Pharmacia),RPR-112378 (Aventis), Vincristine sulfate, DZ-3358 (Daiichi), FR-182877(Fujisawa, i.e. WS-9885B), GS-164 (Takeda), GS-198 (Takeda), KAR-2(Hungarian Academy of Sciences), BSF-223651 (BASF, i.e. ILX-651 andLU-223651), SAH-49960 (Lilly/Novartis), SDZ-268970 (Lilly/Novartis),AM-97 (Armad/Kyowa Hakko), AM-132 (Armad), AM-138 (Armad/Kyowa Hakko),IDN-5005 (Indena), Cryptophycin 52 (i.e. LY-355703), AC-7739 (Ajinomoto,i.e. AVE-8063A and CS-39.HCl), AC-7700 (Ajinomoto, i.e. AVE-8062,AVE-8062A, CS-39-L-Ser.HCl, and RPR-258062A), Vitilevuamide, TubulysinA, Canadensol, Centaureidin (i.e. NSC-106969), T-138067 (Tularik, i.e.T-67, TL-138067 and TI-138067), COBRA-1 (Parker Hughes Institute, i.e.DDE-261 and WHI-261), H10 (Kansas State University), H16 (Kansas StateUniversity), Oncocidin A1 (i.e. BTO-956 and DIME), DDE-313 (ParkerHughes Institute), Fijianolide B, Laulimalide, SPA-2 (Parker HughesInstitute), SPA-1 (Parker Hughes Institute, i.e. SPIKET-P), 3-IAABU(Cytoskeleton/Mt. Sinai School of Medicine, i.e. MF-569), Narcosine(also known as NSC-5366), Nascapine, D-24851 (Asta Medica), A-105972(Abbott), Hemiasterlin, 3-BAABU (Cytoskeleton/Mt. Sinai School ofMedicine, i.e. MF-191), TMPN (Arizona State University), Vanadoceneacetylacetonate, T-138026 (Tularik), Monsatrol, lnanocine (i.e.NSC-698666), 3-IAABE (Cytoskeleton/Mt. Sinai School of Medicine),A-204197 (Abbott), T-607 (Tuiarik, i.e. T-900607), RPR-115781 (Aventis),Eleutherobins (such as Desmethyleleutherobin, Desaetyleleutherobin,Isoeleutherobin A, and Z-Eleutherobin), Caribaeoside, Caribaeolin,Halichondrin B, D-64131 (Asta Medica), D-68144 (Asta Medica),Diazonamide A, A-293620 (Abbott), NPI-2350 (Nereus), Taccalonolide A,TUB-245 (Aventis), A-259754 (Abbott), Diozostatin, (−)-Phenylahistin(i.e. NSCL-96F037), D-68838 (Asta Medica), D-68836 (Asta Medica),Myoseverin B, D-43411 (Zentaris, i.e. D-81862), A-289099 (Abbott),A-318315 (Abbott), HTI-286 (i.e. SPA-110, trifluoroacetate salt)(Wyeth), D-82317 (Zentaris), D-82318 (Zentaris), SC-12983 (NCI),Resverastatin phosphate sodium, BPR-OY-007 (National Health ResearchInstitutes), and SSR-250411 (Sanofi)), steroids (e.g., dexamethasone),finasteride, aromatase inhibitors, gonadotropin-releasing hormoneagonists (GnRH) such as goserelin or leuprolide, adrenocorticosteroids(e.g., prednisone), progestins (e.g., hydroxyprogesterone caproate,megestrol acetate, medroxyprogesterone acetate), estrogens (e.g.,diethlystilbestrol, ethinyl estradiol), antiestrogen (e.g., tamoxifen),androgens (e.g., testosterone propionate, fluoxymesterone), antiandrogen(e.g., flutamide), immunostimulants (e.g., Bacillus Calmette-Guérin(BCG), levamisole, interleukin-2, alpha-interferon, etc.), monoclonalantibodies (e.g., anti-CD20, anti-HER2, anti-CD52, anti-HLA-DR, andanti-VEGF monoclonal antibodies), immunotoxins (e.g., anti-CD33monoclonal antibody-calicheamicin conjugate, anti-CD22 monoclonalantibody-pseudomonas exotoxin conjugate, etc.), radioimmunotherapy(e.g., anti-CD20 monoclonal antibody conjugated to ¹¹¹In ⁹⁰Y, or ¹³¹I,etc.), triptolide, homoharringtonine, dactinomycin, doxorubicin,epirubicin, topotecan, itraconazole, vindesine, cerivastatin,vincristine, deoxyadenosine, sertraline, pitavastatin, irinotecan,clofazimine, 5-nonyloxytryptamine, vemurafenib, dabrafenib, erlotinib,gefitinib, EGFR inhibitors, epidermal growth factor receptor(EGFR)-targeted therapy or therapeutic (e.g. gefitinib (Iressa™),erlotinib (Tarceva™), cetuximab (Erbitux™), lapatinib (Tykerb™),panitumumab (Vectibix™), vandetanib (Caprelsa™), afatinib/BIBW2992,CI-1033/canertinib, neratinib/HKI-272, CP-724714, TAK-285, AST-1306,ARRY334543, ARRY-380, AG-1478, dacomitinib/PF299804, OSI-420/desmethylerlotinib, AZD8931, AEE788, pelitinib/EKB-569, CUDC-101, WZ8040, WZ4002,WZ3146, AG-490, XL647, PD153035, BMS-599626), sorafenib, imatinib,sunitinib, dasatinib, or the like. In embodiments, the compositionsherein may be used in combination with adjunctive agents that may not beeffective alone, but may contribute to the efficacy of the active agentin treating cancer.

In embodiments, co-administration includes administering one activeagent within 0.5, 1, 2, 4, 6, 8, 10, 12, 16, 20, or 24 hours of a secondactive agent. Co-administration includes administering two active agentssimultaneously, approximately simultaneously (e.g., within about 1, 5,10, 15, 20, or 30 minutes of each other), or sequentially in any order.In embodiments, co-administration can be accomplished by co-formulation,i.e., preparing a single pharmaceutical composition including bothactive agents. In embodiments, the active agents can be formulatedseparately. In embodiments, the active and/or adjunctive agents may belinked or conjugated to one another.

EXAMPLES

Applicants have discovered a unique binding site for a cyclic peptide(the peptide or peptidyl moiety provided herein also referred to hereinas a “meditope”) within the central cavity of the Fab arm of thetherapeutic mAb, cetuximab (1). Applicants demonstrated that this siteis unique to cetuximab and absent in human mAbs. Applicants have alsoshown, biochemically and in cell culture and in animal xenograftstudies, that occupancy of this site does not affect antigen binding.Moreover, Applicants demonstrated that this site can be grafted ontohuman mAbs (“meditope-enabling”), indicating that this peptide bindingsite may for example be used as a beacon for targeting imaging agents oras a “hitch” to tether new functionality to mAbs. Through extensiveengineering, Applicants have improved the affinity of the meditope-Fabinteraction by over 40,000-fold with an estimated half-life that exceedssix days at room temperature. Applicants further demonstrated that thefusion of the meditope to protein L, a Fab-binding protein,significantly improved the affinity and estimated the half-life of thiscomplex to exceed 80 days. Finally, Applicants verified through SPRstudies that conjugation of fluorescent markers, DOTA, GFP and otherprotein domains to the high affinity meditope and to themeditope-protein L (MPL) fusion do not affect the affinity of theMPL-Fab nor the Fab-antigen interactions. Collectively, these data showthat functionality can be “snapped” on to any given meditope-enabledmAb.

CAR T cell therapy, which has produced durable responses especially in Bcell malignancies(2-6), involves the reprogramming of patient T cellswith an artificial receptor consisting of an extracellular antigentargeting moiety, a transmembrane domain and intracellular signalingmodules, including CD3ζ and costimulatory domains of CD28 and/or CD137(4-1BB), to activate the T cell and elicit an immune response. Theantigen-targeting domain of the CAR generally is a tumor antigenrecognizing single chain F variable antibody region (scFv). There is aneed in the art for the ability to: 1) characterize the density of theCARs on the transformed cells, 2) to track administered CAR T cells atany point during the therapy and correlate this distribution totherapeutic outcomes, 3) to rapidly functionalize CAR T cells, and 4) toselectively eliminate CAR T cells if necessary. In embodiments, theconstructs provided herein are capable of meeting these needs.

In embodiments, the constructs provided herein are useful in thefollowing areas: (i) application of super resolution microscopy tocharacterize CAR expression through direct observation of the receptordistribution on the T cells. Applicants have fused a photo-activatableGFP (paGFP) to a high affinity meditope, and demonstrated thatmeditope-enabled mAbs bound to cell-derived receptors can be “counted”and their cluster size can be quantified. Such information can becorrelated with therapeutic efficacy and used in the clinic for “qualitycontrol.” (ii) Imaging of meditope-enabled CAR T cells with aDOTA-conjugated, high affinity meditope in situ. Applicants havedemonstrated that high affinity, conjugated meditopes do not affectantigen binding. Thus, meCAR T cells can be pre-labeled with⁶⁴Cu-DOTA-conjugated, high affinity meditopes and their migration can betraced. Alternatively, meCAR T cells can be administered, allowed tolocalize and proliferate, and then subsequently imaged. Pre-targeted,mAb-based imaging methods as proposed have been demonstrated to producehigh quality PET images using engineered antibodies (9-11). (iii) Novelorthogonal functionality that can be rapidly added to the meCAR T cell.Specifically, meditopes may be conjugated to biologics that recognize asecond tumor-associated ligand, potent cytotoxins, immune modulatorsincluding cytokines, and tumor-activated prodrugs. These meditopes maybe directly attached to the meCAR T cells before administration orsubsequently added after the meCAR T cells are established.

Example 1

Enrichment of CMV-Specific T Cells from PBMC of Healthy Donors afterStimulation with cGMP Grade CMVpp65 Protein

CMV-specific T cells were prepared from PBMC of healthy donors bystimulating the PBMC with cGMP grade CMVpp65 protein. Briefly, PBMCswere isolated by density gradient centrifugation over Ficoll-Paque(Pharmacia Biotech, Piscataway, N.J.) from peripheral blood of consentedhealthy, HLA-A2 CMV-immune donors under a City of Hope Internal ReviewBoard-approved protocol. PBMC were frozen for later use. After overnightrest in RPMI medium containing 5% Human AB serum (Gemini Bio Products)without cytokine, the PBMC were stimulated with current goodmanufacturing practice (cGMP) grade CMVpp65 protein (Miltenyi Biotec,Germany) at 10 ul/10×10⁶ cells for 16 hours in RPMI 1640 (IrvineScientific, Santa Ana, Calif.) supplemented with 2 mM L-glutamine(Irvine Scientific), 25 mMN-2-hydroxyethylpiperazine-N′-2-ethanesulfonic acid (HEPES, IrvineScientific), 100 U/mL penicillin, 0.1 mg/mL streptomycin (IrvineScientific) in the presence of 5 U/ml IL-2 and 10% human AB serum.CMV-specific T cells were selected using the IFNγ capture (MiltenyiBiotec, Germany) technique according to the manufacturer's instructions.

To demonstrate the consistency of this clinically feasible process, theselection was repeated five times using PBMC from three differentdonors. IFNγ-positive T cells were consistently enriched from a baselinemean of 3.8% (range 1.8-5.6) to a post-capture mean of 71.8% (range61-81) and contained polyclonal CD8⁺ (34%) and CD4⁺ T cells (37%) afterselection (FIG. 14A and FIG. 14C). Moreover, the selected CMV-specific Tcells included both CD4 and CD8 subsets and represented the entirespectrum of CMV-specificity, showing responsiveness to CMVpp65 pepmixstimulation with broad recognition.

Example 2

Genetic Modification of Enriched CMV-Specific T Cells to Express CD19CAR and In Vitro Expansion of the CMV/CAR T Cells.

In the clinically adaptable procedure, IFNγ-captured CMV-specific Tcells were transduced 2 days after the selection, without OKT3activation, using the second generation CD19RCD28EGFRt lentiviralconstruct containing the IgG4 Fc hinge region mutations (L235E; N297Q)that improve potency due to distortion of the FcR binding domain.Starting seven days post lenti-transduction, the cells were stimulatedon a weekly basis with 8000 cGy-irradiated, CD19-expressing NIH3T3 cellsat a 1:10 ratio (T cells:CD19NIH 3T3). The percentage of CAR⁺ cellsdetected by cetuximab increased from 8% post transduction to 46% after 2rounds of stimulation with a 120-150-fold total cell increase (FIG. 14Band FIG. 14D). Further details regarding the lentiviral construct, theCD19-expressing NIH3T3 cells and other materials and techniques used inthe studies described herein are presented below.

Example 3

CMV/CAR T Cells Exhibited Specific Effector Function after StimulationThrough Pre-Defined Viral TCR and CD19CAR.

Recapitulating our previous studies (23), the ex vivo expandedCMV-specific T cells possessed an effector phenotype and no longerexpressed the central memory markers of the originally selected cells,such as CD62L, CD28, and IL-7Ra (FIG. 15A and FIG. 15D). However, levelsof CD27 remained high, suggesting a greater proliferative potential thathas been associated with greater clinical efficacy (24). To investigateCMV/CAR T cell effector function via signaling by both the endogenousCMV-specific TCR and the introduced CD19CAR, we evaluated response toengineered pp65-expressing U251T cells from HLA-A2 donors, and alsoallogeneic CD19⁺ LCLs, based on cytotoxicity, cytokine production andproliferation profiles. As expected, the expanded CMV/CAR T cellsspecifically lysed CD19⁺ LCLs with the same maximum killing levels asthe OKT3-expressing LCL used as positive controls. Likewise, specifickilling was also observed when pp65U251T cells were used as targets ascompared to parental U251T cells (FIG. 15B). Accordingly, afterovernight stimulation, elevated IFNγ secretion was observed after eitherCD19 or pp65 antigen stimulation as compared to antigen-negativestimulators such as KG1a and U251T parental cells (FIG. 15C).

Antibodies and Flow Cytometry: Fluorochrome-conjugated isotype controls,anti-CD3, anti-CD4, anti-CD8, anti-CD28, anti-CD45, anti-CD27,anti-CD62L, anti-CD127, anti-IFN-γ, and streptavidin were obtained fromBD Biosciences. Biotinylated cetuximab was generated from cetuximabpurchased from the City of Hope pharmacy. The IFN-γ Secretion Assay—CellEnrichment and Detection Kit and CMVpp65 protein were purchased fromMiltenyi Biotec (Miltenyi Biotec, Germany). Phycoerythrin(PE)-conjugated CMV pp65 (NLVPMVATV)-HLA-A2*0201 iTAg MHC tetramer,PE-conjugated multi-allele negative tetramer was obtained from BeckmanCoulter (Fullerton, Calif.). Carboxyfluorescein diacetate succinimidylester (CFSE) was purchased from Invitrogen (Carlsbad, Calif.). Allmonoclonal antibodies, tetramers and CFSE were used according to themanufacturer's instructions. Flow cytometry data acquisition wasperformed on a MACSQuant (Miltenyi Biotec, Germany) or FACScalibur (BDBiosciences), and the percentage of cells in a region of analysis wascalculated using FCS Express V3 (De Novo Software).

Cell lines: EBV-transformed lymphoblastoid cell lines (LCLs) were madefrom peripheral blood mononuclear cells (PBMC) as previously described(16). To generate LCL-OKT3, allogeneic LCLs were resuspended innucleofection solution using the Amaxa Nucleofector kit T,OKT3-2A-Hygromycin_pEK plasmid was added to 5 μg/107 cells, the cellswere electroporated using the Amaxa Nucleofector I, and the resultingcells were grown in RPMI 1640 with 10% FCS containing 0.4 mg/mlhygromycin. To generate firefly luciferase+ GFP+ LCLs (fflucGFPLCLs),LCLs were transduced with lentiviral vector encoding eGFP-ffluc. Initialtransduction efficiency was 48.5%, so the GFP+ cells were sorted by FACSfor >98% purity. To generate CD19 NIH3T3 cells, parental NIH3T3 cells(ATCC) were transduced with a retrovirus encoding CD80, CD54 and CD58(17). The established cell line was further engineered to expressCD19GFP by lentiviral transduction. GFP+ cells were purified by FACSsorting and expanded for the use of stimulation of CMV/CAR T cells. Togenerate pp65 stimulator cells, U251T cells derived from humanglioblastoma cells from an HLA A2 donor (ATCC) were transduced with alentiviral vector encoding full length pp65 fused to green fluorescentprotein (GFP). pp65U251T cells were purified by GFP expression usingflow cytometry. Banks of all cell lines were authenticated for thedesired antigen/marker expression by flow cytometry prior tocryopreservation, and thawed cells were cultured for less than 6 monthsprior to use in assays.

Peptides: The pp65 peptide NLVPMVATV (HLA-A 0201 CMVpp65) at >90% puritywas synthesized using automated solid phase peptide synthesis in(Department of Experimental Therapeutics, Beckman Research Institute ofCity of Hope). MP1 GIGFVFTL peptide (HLA-A 0201 influenza) wassynthesized at the City of Hope DNA/RNA Peptide Synthesis Facility,(Duarte, Calif.). pepMix HCMVA (pp65) (pp65pepmix) was purchased fromJPT peptide Technologies (GmbH, Berlin Germany). All peptides were usedaccording to the manufacturer's instructions.

Lentivirus vector construction: The lentivirus CAR construct wasmodified from the previously described CD19-specific scFvFc:ζ chimericimmunoreceptor(18), to create a third-generation vector. The CD19CARcontaining a CD28ζ co-stimulatory domain carries mutations at two sites(L235E; N297Q) within the CH2 region on the IgG4-Fc spacers to ensureenhanced potency and persistence after adoptive transfer. The lentiviralvector also expressed a truncated human epidermal growth factor receptor(huEGFRt), which includes a cetuximab (Erbitux™) binding domain butexcludes the EGF-ligand binding and cytoplasmic signaling domains. A T2Aribosome skip sequence links the codon-optimized CD19R:CD28:ζ sequenceto the huEGFRt sequence, resulting in coordinate expression of bothCD19R:CD28:ζ and EGFRt from a single transcript (CD19CARCD28EGFRt) (19).The CD19RCD28EGFRt DNA sequence (optimized by GeneArt) was then clonedinto a self-inactivating (SIN) lentiviral vector pHIV7 in which the CMVpromoter was replaced by the EF-1α promoter.

Enrichment of CMV-specific T cells after CMVpp65 protein stimulation:PBMCs were isolated by density gradient centrifugation over Ficoll-Paque(Pharmacia Biotech, Piscataway, N.J.) from peripheral blood of consentedhealthy, HLA-A2 CMV-immune donors under a City of Hope Internal ReviewBoard-approved protocol. PBMC were frozen for later use. After overnightrest in RPMI medium containing 5% Human AB serum (Gemini Bio Products)without cytokine, the PBMC were stimulated with current goodmanufacturing practice (cGMP) grade CMVpp65 protein (Miltenyi Biotec,Germany) at 10 μl/10×10⁶ cells for 16 hours in RPMI 1640 (IrvineScientific, Santa Ana, Calif.) supplemented with 2 mM L-glutamine(Irvine Scientific), 25 mMN-2-hydroxyethylpiperazine-N′-2-ethanesulfonic acid (HEPES, IrvineScientific), 100 U/mL penicillin, 0.1 mg/mL streptomycin (IrvineScientific) in the presence of 5 U/ml TL-2 and 10% human AB serum.CMV-specific T cells were selected using the IFNγ capture (MiltenyiBiotec, Germany) technique according to the manufacturer's instructions.

Derivation and expansion of CMV/CAR T cells: The selected CMV-specific Tcells were transduced on day 2 post IFNγ capture with lentiviral vectorexpressing CD19CARCD28EGFRt at MOI 3. Seven to ten days afterlenti-transduction, the CMV/CAR T cells were expanded by stimulationthrough CAR-mediated activation signals using 8000 cGy-irradiatedCD19-expressing NUT 3T3 cells at a 10:1 ratio (T cells:CD19 NTIH3T3)once a week as described (17) in the presence of IL-2 50 U/ml and IL-151 ng/ml. After 2 rounds of expansion, the growth and functionality ofthe CMV/CAR T cells was evaluated in vitro and in vivo.

Intracellular cytokine staining: CMV/CAR T cells (10⁵) were activatedovernight with 105 LCL-OKT3, LCL, or KG1a cells in 96-well tissueculture plates, and with 10⁵ U251T and engineered pp65-expressing U251Tcells (pp65U251T) in 24-well tissue culture plates in the presence ofBrefeldin A (BD Biosciences). The cell mixture was then stained usinganti-CD8, cetuximab and streptavidin, and pp65Tetramer to analyzesurface co-expression of CD8, CAR and CMV-specific TCR, respectively.Cells were then fixed and permeabilized using the BD Cytofix/Cytopermkit (BD Biosciences). After fixation, the T cells were stained with ananti-IFNγ.

CFSE Proliferation assays: CMV/CAR T cells were labeled with 0.5 μM CFSEand co-cultured with stimulator cells LCL-OKT3, LCLs, and pp65 U251T for8 days. Co-cultures with U251T and KG1a cells were used as negativecontrols. Proliferation of CD3- and CAR-positive populations wasdetermined using multicolor flow cytometry.

Cytokine production assays: T cells (10⁵) were co-cultured overnight in96-well tissue culture plates with 105 LCL-OKT3, LCL, or KG1a cells andin 24-well tissue culture plates with 105 U251T and engineeredpp65-expressing U251T cells. Supernatants were then analyzed bycytometric bead array using the Bio-Plex Human Cytokine 17-Plex Panel(Bio-Rad Laboratories) according to the manufacturer's instructions.

Cytotoxicity assays: 4-hour chromium-release assays (CRA) were performedas previously described (20) using effector cells that had beenharvested directly after 2 rounds of CD19 Ag stimulations.

Example 4

Generation, Characterization and Identification of Meditope-Enabled CARConstructs for Immunotherapy.

Different combinations of meditope-enabled Fab- and mAb-based CAR(meCAR) constructs that target HER2 positive tumors are generated,packaged each into a lentivirus, and transduced T-cells to generatemeditope-enabled HER2+-CAR (meHER2+-CAR) T cells. The expression levelsof each meCAR are characterized as well as its affinity for solubleextracellular HER2 with and without a DOTA-conjugated meditope. Finally,the tumor cell killing ability of each construct is quantified in thepresence and absence of a DOTA-conjugated meditope in vitro.

CARs are a tool in the reprogramming of the immune system to recognizeand destroy cancer cells. CARs are generally composed of an antigenrecognition domain (e.g., an scFv), a spacer (e.g., the Fc domain of anIgG or hinge domain of CD8), a transmembrane region and intracellularcostimulatory and activation domains (e.g., CD28 and/or CD137 and CD3 ζchain). In embodiments, an antigen recognition domain composed of ameditope-enabled Fab or mAb provides a unique peptide binding site torapidly and specifically add new functionality through the peptidewithout recourse to extensive re-engineering of the CAR itself. Asnoted, these functionalities may include the ability to image, targetadditional tumor-associated receptors, modulate immune function andselectively kill the CAR T cell. Provided herein are several expressionplasmids for trastuzumab, an anti-HER2 mAb that is in the clinic forHER2 positive tumors and which Applicants have meditope-enabled (1). Theorder of light and heavy chain expression is altered and the efficacy ofdifferent internal ribosome entry sites versus the self-cleaving 2Apeptide sequence (15) are tested. The binding of soluble HER2 isquantified as well as meditope for each construct using a variety ofbinding assays and super resolution microscopy. The in vitrofunctionality of the different CAR constructs is characterized byevaluating in vitro HER2-dependent T cell killing, degranulation,cytokine production and proliferation. The effect of meditope occupancyof the meCAR T cells is characterized using these same assays. Acanonical HER2-specific CAR based on the scFv of trastuzumab aregenerated and characterized, which may serve as a reference point forboth expression and functional assays.

A number of tumors aberrantly express HER2 including breast cancer,sarcomas, and lung cancer. Thus, there have been efforts in developingeffective therapeutics, trastuzumab being one. However, 70% of HER2+cancer patients do not respond to these systemic therapies and in factmay rapidly develop resistance to these agents (16). As such, vaccinesto HER2 as well as HER2+ CAR T cells have been developed to go beyondthe inhibition of HER2 signaling pathways and elicit a powerful immuneresponse. Given the potency of CAR T cells and the possibility ofadverse side effects (17), it is useful to monitor, modulate andpotentially destroy HER2+ CAR T cells. Enabling CAR T cell with ameditope binding site addresses these problems.

Meditope Interaction and Optimization. Described herein is a uniquepeptide binding site within the Fab arm of cetuximab including uniqueamino acid residues lining the site not found in human antibodies. Thissite may be grafted onto human mAbs including trastuzumab, a humanizedanti-CEA, and other mAbs. Peptide binding does not affect the ability ofthe meditope-enabled antibodies to bind to their antigens. Due to theposition of the binding site being in the central cavity of the Fab, thepeptide may be referred to as a “meditope” (“medius” and “topo”) (FIG.1A and FIG. 4A). Meditope-enabled antibodies “memAbs” refer tomeditope-enabled Fabs as meFabs (1).

Multiple of meditope variants have been produced, their affinity measureand crystallographic data accumulated for each. In these studiescritical residues were identified, non-natural amino acids as well asD-amino acids were introduced, and different cyclization strategies tosignificantly improve the binding affinity were used. Further, pointmutations were introduced in the Fab at the meditope-binding interface(version 2) and observed a 100 fold increase in the binding affinity.Through these modifications, the affinity of meditopes increase from 1.2μM to 860 pM at 37° C. (1000-fold increase). In addition, the termini ofthe meditope and protein L are, in embodiments, in close proximity whenbound to the trastuzumab meFab and demonstrated favorable aviditythrough the fusion of meditope to protein L through a short linker(MPL). The affinity of the MPL construct for the original trastuzumabmeFab as measured by Kinexa experiments is K_(D)=14 μM, or 87,000-foldover the affinity of the individual components at 25° C. (data notshown). Assuming that each modification acts independently, a 258million-fold increase in affinity for the combination of a synthetic MPLand the memAb. Fusion of GFP to the MPL construct does not affect memAbbinding and the GFP-MPL binding to memAb does not affect the associationor dissociation kinetics or the affinity of HER2 binding (as shown inAvery et al. (37)).

Alexa Fluor 647-labeled MPL was either co-administered with Alexa Fluor488-labeled memAb to HER2 overexpressing SKBR3 cells or after the cellswere treated with the memAb and extensively washed. In both cases, thelabeled MPL colocalized with the memAb and antigen (data not shown). Inaddition, it was demonstrated by fluorescence microscopy that the fusionof the bulky GFP to the MPL does not affect cell binding (data notshown). Lastly, a photoactivatable GFP was fused to the MPL constructand super-resolution microscopy was used to quantify HER2 receptors onBT474 cells (data not shown).

HER2-specific scFv-derived CAR T cells target and kill HER2-positivetumors. A second-generation HER2-specific CAR was generated composed ofan scFv based on the trastuzumab antibody and intracellular signalingdomains of CD28 and CD3ζ. A self-inactivating (SIN) lentiviral vectorcassette was constructed encoding this HER2-specific scFv CAR(HER2-28ζ), followed by a 2A ribosomal skip sequence and a truncatedCD19 (CD19t), an inert cell surface marker devoid of intracellularsignaling that allows for specific detection of transduced T cells (FIG.2A). The truncated CD19 (CD19t) as provided herein is also referred toas “marker peptide”. The terms “marker peptide” or “tCD19” may be usedinterchangeably throughout. A human central memory T cells (Tcm) wasconstructed to express the HER2-28ζ CAR and CD19t polypeptides vialentiviral transduction, and expanded ex vivo using CD3/CD28 Dynabeads®stimulation and growth in X-Vivo media supplemented with IL-2 and IL-15as per cGMP-compatible manufacturing platform (18).

Using mouse and non-human primate models relevant for human translation,it has been observed that T cells derived from CD62L⁺ Tcm persist in theblood after adoptive transfer, migrate to memory T cell niches in thelymph nodes and bone marrow, re-acquire phenotypic properties of memoryT cells, and respond to antigen challenge in vivo (21, 22, 24, 25). Tcmor CD62L+ memory/naïve T cells may be engineered to expressmeditope-enabled HER2-CARs, taking advantage of the intrinsic long-termpersistence of memory T cells, and the cGMP-compatible manufacturingplatform which has been used to produce clinical products for two phaseI clinical trials (BB-INDs 14645 and 15490) (18).

HER2-28ζ Tcm exhibit potent HER2-specific cytolytic activity in vitroagainst a panel of target cell lines that display both low (MCF7) andhigh (BT-474 and SK-BR-3) HER2 expression levels (FIGS. 3A-3B).Additionally, intracranial injection of HER2-28ζ Tcm can mediateregression of established brain tumors derived from the BT-474 HER2+breast tumor cell line, and result in long term survival for 100% of themice (data not shown).

The synthetic meditope-enabled trastuzumab heavy and the light chainsmay be sublconed into a lentiviral expression vector (FIG. 1A). Sinceeach chain must be produced individually, an IRES motif will beincorporated between the light and heavy chain or use of a ribosomalskip sequence such as the T2A or the 2A sequence [15]. Further, amonomeric CAR using a meditope-enabled Fab may be created. Thus, themonomeric meditope-enabled Fab may be crosslinked with a bivalentmeditope, allowing to regulation of the activity of the CAR T cell. Thetransmembrane domain is replaced with monomeric L-selectin (26) and asimple poly glycine-serine linker is used.

Meditope-enabled CAR T cells. Primary human T cells, for example CD62L+Tcm cells, will be isolated from the peripheral blood of at least threehealthy donors, engineered by lentiviral transduction to expressHER2-CARs, and evaluated in vitro for specificity and functionalactivity. Following expansion of meditope-enabled HER2+ CAR Tcm withOKT3/CD28 Dynabead® and cytokine (IL-2 and IL-15) stimulation, theexpression level of each construct will be characterized by FACS usinganti-CD19 as a marker of cell transduction and anti-Fc for CARexpression, an Alexa fluor 488-labeled, extracellular Her2-Fc constructfor antigen binding, and an Alexa fluor 647-conjugated meditope forfunctional meditope-CAR docking. Positive CAR T cells will be enriched,if necessary, by anti-CD19 magnetic cell selection or FACS. The abilityof each construct, meditope-enabled Fab and meditope enabled mAb, totarget and lyse HER2-positive (low and high HER2-expressing tumor lines;FIGS. 3A-3B) and HER2-negative breast cancer cell lines will be examinedusing standard chromium-release assays, and long-term co-culture assays(24-96 hrs) in the presence and absence of a DOTA-conjugated, highaffinity meditope. To examine the effector function of differentHER2-CAR T cells, HER2-dependent cytokine production will be measured,including secretion of IFNγ and TNFα following co-culture with tumorcells, again in the presence and absence of a DOTA-conjugated, highaffinity meditope. Additionally, markers of activation and cytolyticactivity will be included, namely CD69, Granzyme-B, and CD107a, as wellas markers of cellular exhaustion, including PD-1. Furthermore, theantigen-dependent proliferative capacity of the differentmeditope-enabled HER2-CAR T cells in the presence and absence ofDOTA-conjugated meditope will be measured by flow cytometry dye dilutionanalysis using CSFE. In each case, the results will be compared to thescFv CAR T cell. Methodologies for performing these in vitro functionalassays are readily established in our group (6, 27).

Super resolution microscopy and autocorrelation analysis (28) will beused to investigate the distribution of receptors for eachmeditope-enabled CAR T cell. This approach will allow to quantitativelydetermine the size, occupancy, and density of proteins in the clusters.As demonstrated herein, an ultra-high affinity paGFP-MPL construct wasproduced and super resolution microscopy was utilized to detect singlemolecules with 15 nm resolution. In addition, a fluorescently labeled,high affinity 15-mer meditope was produced, which is less stericallyconstrained than the paGFP-MPL for super-resolution imaging. Using thesereagents, ˜12 individual cells expressing the meditope-enabled Fab ormAb will be analyzed and the efficacy of the meCAR T cell will becorrelated with receptor distribution.

Example 5

Efficacy and in vivo imaging of meditope-enabled CAR in animal models.The efficacy of meditope-enabled CAR T cells on tumor growth inhibitionwill be evaluated and PET will be used to image meHER2+-CAR T cellspre-treated with ⁶⁴Cu-labeled, DOTA-conjugated meditopes in NSG mice.NSG mice will be treated with the meHER2-CAR T cells and ⁶⁴Cu labeled,DOTA-conjugated meditope will be administered at defined time points toassess meditope uptake by the meHER2-CAR T cells in situ.

Pre-targeted imaging separates the slow accumulation of mAbs at thetumor and slow clearance of mAbs from the blood from the relativelyshort half-life of useful PET metals through a two-step process. First,the patient is administered a conjugated mAb (streptavidin or with aunique binding domain) and then a homing ligand carrying ⁶⁴Cu. Thehoming ligand rapidly binds to the tumor associated, modified mAb or israpidly excreted. Since the ⁶⁴Cu undergoes less half-lives, the signalis higher. Also, since the tracer is rapidly cleared, the background isreduced. Pre-clinical images using this approach have producedsignificantly better images than direct conjugation methods (10).Imaging CAR T cell location, expansion and longevity in patients will betremendously useful in the development and clinical evaluation of thistherapy. In vivo CAR T cell mouse models for the treatment of solidtumors, including brain tumors (FIG. 5 ), are well established in ourlab (27, 34).

A dual orthotropic and metastatic tumor xenograft model will be employedusing female NOD-scid IL2Rγnull (NSG) mice and the HER2-amplified breastcancer line BT474 that has been engineered to express both fireflyluciferase (ffLuc) for non-invasive Xenogen imaging and a fluorescentreporter EGFP (27). EGFP-ffLuc+BT474 tumor cells will be implantedconcurrently into the mammary fat pad (1×10⁶ in a 50 μL mixture of PBSand Matrigel) to model primary disease, and intracranially (1×10⁵ in 2μL PBS) to model metastatic disease. Once tumors are established(typically 7-14 days), a single dose of 5×10⁶ each HER2-meCAR Tcm orun-engineered Tcm (mock) or PBS will be infused intravenously. It hasbeen shown that i.v. administered CAR T cell do traffic to the brain andmediate tumor regression (35, 36). Tumor growth/regression will benon-invasively quantified by Xenogen® IVIS optical imaging and calipermeasurement, and survival analyzed by Kaplan-Meier. For these studies, Tcell infiltration and persistence in tumors will be evaluated byimmunohistochemistry using an Alexa Fluor-labeled meditope and CD3markers, and Tcm persistence will be quantified by flow cytometry usingAlexa Fluor-labeled meditopes, CD45, CD4/CD8, and CD62L markers intumors and lymphoid tissue. Proliferation/apoptosis in tumors (Ki67,TUNEL), CAR T-cell activation and cytolytic function (CD69, Granzyme B,IFNγ) in tumors and in lymphoid tissues will be measured by flowcytometry. In vivo efficacy of meCAR T cells will be compared topreviously characterized HER2-28ζ scFv CAR T cells. These studies willestablish the capacity of meCAR T cells to mediate HER2+ tumorregression, and reveal potential differences in anti-tumor activity andT cell persistence between the meFab or memAb CAR T cells.

The high-affinity meditope with a C-terminal DOTA will be directlysynthesized. The DOTA-meditope will be charged with ⁶⁴Cu, purified bygel chromatography and mixed with the meCAR T cells. The cells will beadministered to animals bearing EGFP-ffLuc+ BT474 tumors. MicroPETimaging will be conducted immediately following the injection and atdefined time points thereafter. At day 1 and day 2, animals will besacrificed and the bio distribution of the meditope and meCAR T cellswill be determined for meCAR T cells at primary and metastatic diseasesites. Next, pre-targeted imaging methods will be applied. The meCAR Tcells will be administered in the same orthotopic and metastaticxenograft model. ⁶⁴CU-DOTA meditope will be administered at 1 h postmeCAR T cell administration and imaged at defined points thereafter (1,2, 3 and 6 hours). The same imaging schedule will be conducted 1 day, 3days and 10 days post meCAR T cell administration. Again, animals willbe sacrificed and the bio distribution(s) will be determined throughradiography.

Example 6

Genetic Modification of Enriched CMV-Specific T Cells to ExpressSecond-Generation HER2-Specific CAR and In Vitro Expansion of theCMV/Meditope-Enabled CAR T Cells.

IFNγ-captured CMV-specific T cells will be transduced 2 days after theselection, without OKT3 activation, using the lentiviral constructencoding the meditope (me)-enabled trastuzumab Fab-CAR cassette(meHER2), with the T2A ribosomal skip sequence separating the antibodylight chain (meLc) and the heavy chain fused to the IgG4-CH3-Fc linker,CD28 transmembrane domain (Tm) and the CD28 and CD3ζ cytoplasmicsignaling domains (Hc28ζ). Expression is driven by the EF1α promoter andtested in two orientations: Lc-Hc28ζ and Hc28ζ-Lc. (FIG. 11A). Aminoacid sequences of exemplary meHER2-CARs are set forth in SEQ ID NO:17and SEQ ID NO:28. Starting seven days post lentiviral transduction, thecells will be stimulated on a weekly basis with 8000 cGy-irradiated,HER2-expressing feeder cells (e.g., HER2⁺ breast cancer lines) at a 1:10ratio (T cells:feeder cells). The percentage of CAR⁺ cells will bedetermined by detection using trastuzumab or protein L staining, whichbinds the Fab light chain, confirms cell surface expression of both CARorientations. Meditope-AF647 staining will confirm the functionalformation of the CAR meditope pocket.

To investigate CMV/meCAR T cell effector function via signaling by boththe endogenous CMV-specific TCR and the introduced meHER2-CAR, we willevaluate response to engineered pp65-expressing U251T cells from HLA-A2donors, and also allogeneic HER2⁺ cells, based on cytotoxicity, cytokineproduction and proliferation profiles.

Further, the ability of CMV/meCAR T cells, to target and lyseHER2-positive (low and high HER2-expressing tumor lines) andHER2-negative breast cancer cell lines will be examined using standardchromium-release assays, and long-term co-culture assays (24-96 hrs) inthe presence and absence of a DOTA-conjugated, high affinity meditope.To examine the effector function of different CMV/HER2-CAR T cells,HER2-dependent cytokine production will be measured, including secretionof IFNγ and TNFα following co-culture with tumor cells, again in thepresence and absence of a DOTA-conjugated, high affinity meditope.Additionally, markers of activation and cytolytic activity will beincluded, namely CD69, Granzyme-B, and CD107a, as well as markers ofcellular exhaustion, including PD-1. Furthermore, the antigen-dependentproliferative capacity of the different CMV/meditope-enabled HER2-CAR Tcells in the presence and absence of DOTA-conjugated meditope will bemeasured by flow cytometry dye dilution analysis using CSFE. In eachcase, the results will be compared to the scFv CAR T cell. Methodologiesfor performing these in vitro functional assays are readily establishedin our group (6, 27).

Efficacy and In Vivo Imaging of Meditope-Enabled CAR in Animal Models.

The efficacy of CMV/meditope-enabled CAR T cells on tumor growthinhibition will be evaluated and PET will be used to imageCMV/meHER2+-CAR T cells pre-treated with ⁶⁴Cu-labeled, DOTA-conjugatedmeditopes in NSG mice. NSG mice will be treated with the CMV/meHER2-CART cells and ⁶⁴Cu labeled, DOTA-conjugated meditope will be administeredat defined time points to assess meditope uptake by the CMV/meHER2-CAR Tcells in situ. A single dose of 5×10⁶ each CMV/HER2-meCAR Tcm orun-engineered Tcm (mock) or PBS will be infused intravenously. Thehigh-affinity meditope with a C-terminal DOTA will be directlysynthesized. The DOTA-meditope will be charged with 64Cu, purified bygel chromatography and mixed with the CMV/meCAR T cells. The cells willbe administered to animals bearing EGFP-ffLuc+ BT474 tumors. MicroPETimaging will be conducted immediately following the injection and atdefined time points thereafter. At day 1 and day 2, animals will besacrificed and the bio distribution of the meditope and CMV/meCAR Tcells will be determined for CMV/meCAR T cells at primary and metastaticdisease sites. Next, pre-targeted imaging methods will be applied. TheCMV/meCAR T cells will be administered in the same orthotopic andmetastatic xenograft model. 64CU-DOTA meditope will be administered at 1h post CMV/meCAR T cell administration and imaged at defined pointsthereafter (1, 2, 3 and 6 hours). The same imaging schedule will beconducted 1 day, 3 days and 10 days post CMV/meCAR T celladministration. Again, animals will be sacrificed and the biodistribution(s) will be determined through radiography.

Derivation and expansion of CMV/meCAR T cells: The selected CMV-specificT cells were transduced on day 2 post IFNγ capture with lentiviralvector expressing meditope (me)-enabled trastuzumab Fab-CAR cassette(meHER2), with the T2A ribosomal skip sequence separating the antibodylight chain (meLc) and the heavy chain fused to the IgG4-CH3-Fc linker,CD28 transmembrane domain (Tm) and the CD28 and CD3ζ cytoplasmicsignaling domains (Hc28ζ). at MOI 3. Seven to ten days afterlenti-transduction, the CMV/meCAR T cells were expanded by stimulationthrough CAR-mediated activation signals using 8000 cGy-irradiatedHER2-expressing feeder cells (e.g., HER2⁺ breast cancer lines) at a 1:10ratio (T cells:feeder cells) once a week as described (17) in thepresence of IL-2 50U/ml and IL-15 1 ng/ml. After 2 rounds of expansion,the growth and functionality of the CMV/meCAR T cells was evaluated invitro and in vivo.

CFSE Proliferation assays: CMV/meCAR T cells were labeled with 0.5 μMCFSE and co-cultured with stimulator cells LCL-OKT3, HER2⁺ cells, andpp65 U251T for 8 days. Co-cultures with U251T and KG1a cells were usedas negative controls. Proliferation of CD3- and CAR-positive populationswas determined using multicolor flow cytometry.

Cytokine production assays: T cells (10⁵) were co-cultured overnight in96-well tissue culture plates with 105 LCL-OKT3, HER2⁺ cells, or KG1acells and in 24-well tissue culture plates with 105 U251T and engineeredpp65-expressing U251T cells. Supernatants were then analyzed bycytometric bead array using the Bio-Plex Human Cytokine 17-Plex Panel(Bio-Rad Laboratories) according to the manufacturer's instructions.

Cytotoxicity assays: 4-hour chromium-release assays (CRA) were performedas previously described (20) using effector cells that had beenharvested directly after 2 rounds of HER2⁺ Ag stimulations.

Tables

TABLE 1 Examples of transmembrane domains. NCBI Protein Accession No.Length Transmembrane Domain Sequence CD3z GI:623041 21 aaLCYLLDGILFIYGVILTALFL (SEQ ID NO: 1) CD28 GE340545506 27 aaFWVLVVVGGVLACYSLLVTVAFIIFWV (SEQ ID NO: 2) CD4 GI:179143 22 aaMALIVLGGVAGLLLFIGLGIFF (SEQ ID NO: 3) CD8 GI:225007534 21 aaIYIWAPLAGTCGVLLLSLVIT (SEQ ID NO: 4) CD8 GI:225007534 23 aaIYIWAPLAGTCGVLLLSLVITLY (SEQ ID NO: 5) CD8 GI:225007534 24 aaIYIWAPLAGTCGVLLLSLVITLYC (SEQ ID NO: 6) 41BB GI:315259099 27 aaIISFFLALTSTALLFLLFF LTLRFSVV (SEQ ID NO: 7) OX40 GI:315360637 21 aaVAAILGLGLVLGLLGPLAILL (SEQ ID NO: 8) ICOS GI:251823951 21 aaFWLPIGCAAFVVVCILGCILI (SEQ ID NO: 9) CD62L GI:262206314 23 aaPLFIPVAVMVTAFSGLAFIIWLA (SEQ ID NO: 10)

TABLE 2 Examples of signaling domains NCBI Accession Protein No. LengthEndo Signaling CD37 GI:623041 113 aa SEQ ID NO: 11:RVKFSRSADAPAYQQGQNQLYNELNLGRREEYD VLDKRRGRDPEMGGKPQRRKNPQEGLY CD28GI:340545506  42 aa SEQ ID NO: 12: RSKRSRLLHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRS CD28gg* GI:340545506  42 aa SEQ ID NO: 13:RSKRSRGGHSDYMNMTPRRPGPTRKHYQPYAPPR DFAAYRS (ref) 41BB GI:315259099 42 aa SEQ ID NO: 14: KRGRKKLLYIFKQPFMRPVQTTQEEDGCSCRFPEE EEGGCEL OX40GI:315360637  42 aa SEQ ID NO: 15: ALYLLRRDQRLPPDAHKPPGGGSFRTPIQEEQADAHSTLAKI ICOS GI:251823951  38 aa SEQ ID NO: 16:CWLTKKKYSSSVHDPNGEYMFMRAVNTAKKSRL TDVTL

TABLE 3 Examples of transmembrane domains. Name Accession LengthSequence CD3z J04132.1 21 aa LCYLLDGILFIYGVILTALFL (SEQ ID NO: 111) CD28NM_006139 27 aa FWVLVVVGGVLACYSLLVTVAFIIFWV (SEQ ID NO: 112) CD28(M)NM_006139 28 aa MFWVLVVVGGVLACYSLLVTVAFIIFWV (SEQ ID NO: 113) CD4 M3516022 aa MALIVLGGVAGLLLFIGLGIFF (SEQ ID NO: 114) CD8tm NM_001768 21 aaIYIWAPLAGTCGVLLLSLVIT (SEQ ID NO: 115) CD8tm2 NM_001768 23 aaIYIWAPLAGTCGVLLLSLVITLY (SEQ ID NO: 116) CD8tm3 NM_001768 24 aaIYIWAPLAGTCGVLLLSLVITLYC (SEQ ID NO: 117) 41BB NM_001561 27 aaIISFFLALTSTALLFLLFF LTLRFSVV (SEQ ID NO: 118)

TABLE 4 Examples of spacer regions. Name Length Sequence a3   3 aa AAAlinker  10 aa GGGSSGGGSG (SEQ ID NO: 100) IgG4 hinge (S→P)  12 aaESKYGPPCPPCP (SEQ ID NO: 101) (S228P) IgG4 hinge  12 aaESKYGPPCPSCP (SEQ ID NO: 102) IgG4 hinge (S228P) +  22 aaESKYGPPCPPCPGGGSSGGGSG (SEQ linker ID NO: 103) CD28 hinge  39 aaIEVMYPPPYLDNEKSNGTIIHVKGKH LCPSPLFPGPSKP (SEQ ID NO: 104)CD8 hinge-48 aa  48 aa AKPTTTPAPRPPTPAPTIASQPLSLRP EACRPAAGGAVHTRGLDFACD(SEQ ID NO: 105) CD8 hinge-45 aa  45 aa TTTPAPRPPTPAPTIASQPLSLRPEACRPAAGGAVHTRGLDFACD (SEQ ID NO: 106) IgG4(HL-CH3) 129 aaESKYGPPCPPCPGGGSSGGGSGGQP (includes S228P in hinge)REPQVYTLPPSQEEMTKNQVSLTCL VKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQ EGNVFSCSVMHEALHNHYTQKSLSLSLGK (SEQ ID NO: 107) IgG4 229 aa ESKYGPPCPSCPAPEFEGGPSVFLFPP(L235E, N297Q) KPKDTLMISRTPEVTCVVVDVSQED PEVQFNWYVDGVEVHQAKTKPREEQFQSTYRVVSVLTVLHQDWLNGKE YKCKVSNKGLPSSIEKTISKAKGQPREPQVYTLPPSQEEMTKNQVSLTCLV KGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQE GNVFSCSVMHEALHNHYTQKSLSLS LGK (SEQ ID NO: 108)IgG4 229 aa ESKYGPPCPPCPAPEFEGGPSVFLFPP (S228P, L235E, N297Q)KPKDTLMISRTPEVTCVVVDVSQED PEVQFNWYVDGVEVHQAKTKPREEQFQSTYRVVSVLTVLHQDWLNGKE YKCKVSNKGLPSSIEKTISKAKGQPREPQVYTLPPSQEEMTKNQVSLTCLV KGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQE GNVFSCSVMHEALHNHYTQKSLSLS LGK (SEQ ID NO: 109)IgG4(CH3) 107 aa GQPREPQVYTLPPSQEEMTKNQVSL TCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSR WQEGNVFSCSVMHEALHNHYTQKSLSLSLGK (SEQ ID NO: 110)

TABLE 5 CD3G Domain and Examples of Costimulatory Domains. NameAccession Length Sequence CD3ζ J04132.1 113 aaRVKFSRSADAPAYQQGQNQLYNELNL GRREEYDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKG ERRRGKGHDGLYQGLSTATKDTYDALHMQALPPR (SEQ ID NO: 119) CD28 NM_006139  42 aaRSKRSRLLHSDYMNMTPRRPGPTRKHYQ PYAPPRDFAAYRS (SEQ ID NO: 120) CD28gg*NM_006139  42 aa RSKRSRGGHSDYMNMTPRRPGPTRKHYQPYAPPRDFAAYRS (SEQ ID NO: 121) 41BB NM_001561  42 aaKRGRKKLLYIFKQPFMRPVQTTQEEDGC SCRFPEEEEGGCEL (SEQ ID NO: 122) OX40  42 aaALYLLRRDQRLPPDAHKPPGGGSFRTPIQ EEQADAHSTLAKI (SEQ ID NO: 123)

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P1 Embodiments

P1 Embodiment 1. An isolated nucleic acid encoding a protein comprising:(i) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and (ii) a transmembrane domain.

P1 Embodiment 2. The isolated nucleic acid of P1 Embodiment 1, whereinsaid antibody region is an antibody fragment.

P1 Embodiment 3. The isolated nucleic acid of P1 Embodiment 1 or 2,wherein said antibody region comprises an Fc domain.

P1 Embodiment 4. The isolated nucleic acid of one of P1 Embodiments 1 to3, wherein said antibody region is a humanized antibody region.

P1 Embodiment 5. The isolated nucleic acid of one of P1 Embodiment 1 to4, further comprising an intracellular T-cell signaling sequenceencoding an intracellular T-cell signaling domain.

P1 Embodiment 6. The isolated nucleic acid of P1 Embodiment 5, whereinsaid intracellular T-cell signaling domain is a CD3 (intracellularT-cell signaling domain.

P1 Embodiment 7. The isolated nucleic acid of one of P1 Embodiments 1-6further comprising an intracellular co-stimulatory signaling sequenceencoding an intracellular co-stimulatory signaling domain.

P1 Embodiment 8. The isolated nucleic acid of P1 Embodiment 7, whereinsaid intracellular co-stimulatory signaling domain is a CD28intracellular co-stimulatory signaling domain, a 4-1BB intracellularco-stimulatory signaling domain, a ICOS intracellular co-stimulatorysignaling domain, or an OX-40 intracellular co-stimulatory signalingdomain.

P1 Embodiment 9. The isolated nucleic acid of one of P1 Embodiments 1-8further comprising a spacer sequence encoding a spacer region.

P1 Embodiment 10. The isolated nucleic acid of P1 Embodiment 9, whereinsaid spacer region is between said transmembrane domain and saidantibody region.

P1 Embodiment 11. The isolated nucleic acid of one of P1 Embodiments1-10 further comprising a linker sequence encoding a linker domain.

P1 Embodiment 12. The isolated nucleic acid of P1 Embodiment 11, whereinsaid linker domain is between said transmembrane domain and saidintracellular T-cell signaling domain.

P1 Embodiment 13. The isolated nucleic acid of P1 Embodiment 11, whereinsaid linker domain is between said intracellular T-cell signaling domainand said intracellular co-stimulatory signaling domain.

P1 Embodiment 14. The isolated nucleic acid of P1 Embodiment 11, whereinsaid linker domain comprises the sequence GGCGG or GGG.

P1 Embodiment 15. The isolated nucleic acid of one of P1 Embodiments 1to 14 comprising: (i) a heavy chain sequence encoding a heavy chaindomain of said protein, said heavy chain domain comprising a variableheavy chain domain and said transmembrane domain; and (ii) a light chainsequence encoding a light chain domain of said protein, said light chaindomain comprising a variable light chain domain, wherein said variableheavy chain domain and said variable light chain domain together form atleast a portion of said antibody region.

P1 Embodiment 16. The isolated nucleic acid of P1 Embodiment 15comprising a self-P1 Embodiment 17. The isolated nucleic acid of P1Embodiment 16, wherein said self-cleaving peptidyl linker sequence is aT2A sequence or a 2A sequence.

P1 Embodiment 18. The isolated nucleic acid of one of P1 Embodiments 15to 17, wherein said light chain sequence is 3′ to said heavy chainsequence.

P1 Embodiment 19. The isolated nucleic acid of one of P1 Embodiments 1to 18, wherein said antibody region is a cetuximab meditope enableddomain, trastuzumab meditope enabled domain, pertuzumab meditope enableddomain, M5A meditope enabled domain or rituximab meditope enableddomain.

P1 Embodiment 20. An isolated nucleic acid encoding a protein comprisinga first portion comprising an antibody heavy chain variable domain and asecond portion comprising an antibody light chain variable domain and anantibody light chain constant domain, wherein the first portion furthercomprises a transmembrane domain.

P1 Embodiment 21. The isolated nucleic acid of P1 Embodiment 20, whereinsaid first portion further comprises an intracellular T-cell signalingdomain.

P1 Embodiment 22. The isolated nucleic acid of P1 Embodiment 20, whereinsaid intracellular T-cell signaling domain is a CD3 (intracellularT-cell signaling domain.

P1 Embodiment 23. The isolated nucleic acid of one of P1 Embodiments20-22, wherein said first portion further comprises an intracellularco-stimulatory signaling domain.

P1 Embodiment 24. The isolated nucleic acid of P1 Embodiment 23, whereinsaid intracellular co-stimulatory signaling domain is a CD28intracellular co-stimulatory signaling domain, a 4-1BB intracellularco-stimulatory signaling domain, a ICOS intracellular co-stimulatorysignaling domain, or an OX-40 intracellular co-stimulatory signalingdomain.

P1 Embodiment 25. The isolated nucleic acid of one of P1 Embodiments20-24 wherein said first portion further comprises a linker domain.

P1 Embodiment 26. The isolated nucleic acid of P1 Embodiment 25, whereinsaid linker domain is between said transmembrane domain and saidintracellular T-cell signaling domain.

P1 Embodiment 27. The isolated nucleic acid of P1 Embodiment 25, whereinsaid linker domain is between said intracellular T-cell signaling domainand said intracellular co-stimulatory signaling domain.

P1 Embodiment 28. The isolated nucleic acid of P1 Embodiment 25, whereinsaid linker domain comprises the sequence GGCGG or GGG.

P1 Embodiment 29. The isolated nucleic acid of P1 Embodiment 20, whereinsaid first portion further comprises a CD3 (intracellular T-cellsignaling domain and an intracellular co-stimulatory signaling domain.

P1 Embodiment 30. The isolated nucleic acid molecule of P1 Embodiment23, wherein the first portion comprises from the amino terminus to thecarboxy terminus: the heavy chain variable domain, a heavy chainconstant domain, the transmembrane domain, the CD3 (intracellular T-cellsignaling domain and an intracellular co-stimulatory signaling domain.

P1 Embodiment 31. The isolated nucleic acid molecule of one of P1Embodiments 20-30 further comprising a spacer region positioned betweenthe heavy chain variable domain and the transmembrane domain.

P1 Embodiment 32. The isolated nucleic acid of P1 Embodiment 31, whereinsaid spacer region further comprises a hinge region.

P1 Embodiment 33. The isolated nucleic acid of P1 Embodiment 20, whereinthe antibody heavy chain variable domain and the antibody light chainvariable domain are humanized.

P1 Embodiment 34. The isolated nucleic acid of P1 Embodiment 20, whereinsaid first portion comprises a heavy chain constant domain.

P1 Embodiment 35. The isolated nucleic acid of P1 Embodiment 20comprising a self-cleaving peptidyl sequence between said first portionand said second portion.

P1 Embodiment 36. The isolated nucleic acid of P1 Embodiment 35, whereinsaid self-cleaving peptidyl encoding sequence is a T2A encoding sequenceor a 2A encoding sequence.

P1 Embodiment 37. The isolated nucleic acid of one of P1 Embodiment 20,wherein the nucleic acid sequence encoding the second portion is 3′ tothe nucleic acid sequence encoding the first portion.

P1 Embodiment 38. The isolated nucleic acid of one of P1 Embodiment 1 to37, wherein said protein is an anti-CD19 protein, anti-CD20 protein,anti-CD22 protein, anti-CD30 protein, anti-CD33 protein, anti-CD44v6/7/8protein, anti-CD123 protein, anti-CEA protein, anti-EGP-2 protein,anti-EGP-40 protein, anti-erb-B2 protein, anti-erb-B2,3,4 protein,anti-FBP protein, anti-fetal acetylcholine receptor protein, anti-GD2protein, anti-GD3 protein, anti-Her2/neu protein, anti-IL-13R-a2protein, anti-KDR protein, anti k-light chain protein, anti-LeY protein,anti-L1 cell adhesion molecule protein, anti-MAGE-A1 protein,anti-mesothelin protein, anti-murine CMV infected cell protein,anti-MUC2 protein, anti-NKGD2 protein, anti, oncofetal antigen protein,anti-PCSA protein, anti-PSMA protein, anti-TAA (targeted by mAb IfE)protein, anti-EGFR protein, anti-TAG-72 protein or anti-VEGF-72 protein.

P1 Embodiment 39. The isolated nucleic acid of one of P1 Embodiments 1to 38, further comprising a suicide gene sequence.

P1 Embodiment 40. An expression vector comprising the nucleic acid ofone of P1 Embodiments 1 to 39.

P1 Embodiment 41. The expression vector of P1 Embodiment 40, whereinsaid expression vector is a viral vector.

P1 Embodiment 42. The expression vector of P1 Embodiment 41, whereinsaid virus is a lentivirus or onco-retrovirus.

P1 Embodiment 43. A T lymphocyte comprising the expression vector of oneof P1 Embodiments 40 to 42.

P1 Embodiment 44. A T lymphocyte of P1 Embodiment 43, comprising a firstpolypeptide and a second polypeptide, the first polypeptide comprising aheavy chain variable domain, a heavy chain constant domain, atransmembrane domain, a CD3 (signaling domain and a co-stimulatoryT-cell signaling domain, the second polypeptide comprising a light chainvariable domain and an light chain constant domain.

P1 Embodiment 45. A recombinant protein comprising: (i) an antibodyregion comprising a central cavity formed by a heavy chain variable (VH)region and a light chain variable (VL) region, wherein said centralcavity forms a peptide binding site comprising framework region aminoacid residues; and (ii) a transmembrane domain.

P1 Embodiment 46. The recombinant protein of P1 Embodiment 45, whereinsaid antibody region further comprises a heavy chain constant region(CH) and a light chain constant region (CL).

P1 Embodiment 47. The recombinant protein of P1 Embodiment 45 or 46,wherein said antibody region comprises an Fc domain.

P1 Embodiment 48. The recombinant protein of one of P1 Embodiments 45 to47, wherein said antibody region is a humanized antibody region.

P1 Embodiment 49. The recombinant protein of one of P1 Embodiments 45 to48, wherein said antibody region does not comprise a scFv antibodyregion.

P1 Embodiment 50. The recombinant protein of one of P1 Embodiments 45 to49, wherein said protein further comprises an intracellular T-cellsignaling domain.

P1 Embodiment 51. The recombinant protein of P1 Embodiment 50, whereinsaid intracellular T-cell signaling domain is a CD3 (intracellularT-cell signaling domain.

P1 Embodiment 52. The recombinant protein of one of P1 Embodiments 45 to51, further comprising an intracellular co-stimulatory signaling domain.

P1 Embodiment 53. The recombinant protein of P1 Embodiment 52, whereinsaid intracellular co-stimulatory signaling domain is a CD28intracellular co-stimulatory signaling domain, a 4-1BB intracellularco-stimulatory signaling domain, a ICOS intracellular co-stimulatorysignaling domain, or an OX-40 intracellular co-stimulatory signalingdomain.

P1 Embodiment 54. The recombinant protein of one of P1 Embodiments 45 to53, further comprising a spacer region.

P1 Embodiment 55. The recombinant protein of P1 Embodiment 54, whereinsaid spacer region is between said transmembrane domain and saidantibody region.

P1 Embodiment 56. The recombinant protein of P1 Embodiment one of P1Embodiments 45-55, further comprising a linker domain.

P1 Embodiment 57. The recombinant protein of P1 Embodiment 56, whereinsaid linker domain is between said transmembrane domain and saidintracellular T-cell signaling domain.

P1 Embodiment 58. The recombinant protein of P1 Embodiment 56, whereinsaid linker domain is between said intracellular T-cell signaling domainand said intracellular co-stimulatory signaling domain.

P1 Embodiment 59. The recombinant protein of P1 Embodiment 57 or 58,wherein said linker domain comprises the sequence GGCGG or GGG.

P1 Embodiment 60. The recombinant protein of one of P1 Embodiments 45 to59, wherein said antibody region is a cetuximab meditope enabled domain,trasuzumab meditope enabled domain, pertuzumab meditope enabled domain,M5A meditope enabled domain or rituximab meditope enabled domain.

P1 Embodiment 61. The recombinant protein of one of P1 Embodiments 45 to60, wherein a compound comprising an peptidyl moiety is bound to saidpeptide binding site.

P1 Embodiment 62. The recombinant protein of P1 Embodiment 61, whereinsaid compound is a multivalent meditope.

P1 Embodiment 63. A recombinant protein comprising a first portioncomprising an antibody heavy chain variable domain and a second portioncomprising an antibody light chain variable domain and an antibody lightchain constant domain, wherein the first portion further comprises atransmembrane domain, and wherein said antibody heavy chain variabledomain, said antibody light chain variable domain and said antibodylight chain constant domain together form an antibody region.

P1 Embodiment 64. A T lymphocyte comprising the recombinant protein ofone of P1 Embodiments 45 to 63, wherein said transmembrane domain iswithin the cell membrane of said T lymphocyte.

P1 Embodiment 65. A method of treating cancer, said method comprisingadministering to a subject in need thereof an effective amount of theT-lymphocyte of P1 Embodiment 64, wherein said antibody region is ananti-cancer antibody region.

P1 Embodiment 66. The method of P1 Embodiment 65, wherein saidT-lymphocyte is an autologous T-lymphocyte.

P1 Embodiment 67. The method of P1 Embodiment 65, wherein saidT-lymphocyte is a heterologous T-lymphocyte.

P1 Embodiment 68. The method of P1 Embodiment 65, wherein said cancer isa solid tumor cancer or hematologic malignancy.

P1 Embodiment 69. The method of one of P1 Embodiments 65 to 68, whereinsaid cancer is ovarian cancer, renal cell carcinoma, a B-cellmalignancy, leukemia, lymphoma, breast cancer, colorectal cancer,prostate cancer, neuroblastoma, melanoma, medulloblastoma, lung cancer,osteosarcoma, glioblastoma or glioma.

P1 Embodiment 70. A method of reprogramming a T lymphocyte, said methodcomprising contacting a T lymphocyte with the expression vector of oneof P1 Embodiments 40 to 42.

P1 Embodiment 71. A method of detecting a cancer, said methodcomprising: (i) administering to a cancer patient an effective amount ofa T lymphocyte comprising the recombinant protein of one of P1Embodiments 45 to 63 and a compound comprising a peptidyl moiety capableof binding to said peptide binding site, wherein said compound furthercomprises a detectable label, and wherein said antibody region is ananti-cancer antibody region; (ii) allowing said compound to bind to saidpeptide binding site thereby forming a recombinant protein-compoundcomplex; and (iii) detecting said recombinant protein-compound complexwithin said cancer patient thereby detecting said cancer.

P1 Embodiment 72. A T lymphocyte comprising the isolated nucleic acid ofP1 Embodiment 1.

P2 Embodiments

P2 Embodiment 1. A method for treating a patient comprising:

(i) providing a composition comprising a population of T cellsexpressing a T cell receptor specific for a cytomegalovirus (CMV)antigen and a recombinant CAR protein,

wherein said recombinant CAR protein comprises:

(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain;(ii) administering the composition to the patient; and(iii) administering to the patient a viral vector encoding: (i) CMV pp65and (ii) a fusion protein comprising exon 4 of CMV protein IE1 (e4) andexon 5 of CMV protein IE2 (e5) either prior to or subsequent toadministering the composition comprising a population of T cells to thepatient.

P2 Embodiment 2. The method of P2 Embodiment 1, wherein said antibodyregion is an antibody fragment.

P2 Embodiment 3. The method of P2 Embodiment 1, wherein said antibodyregion comprises an Fc domain.

P2 Embodiment 4. The method of P2 Embodiment 1, wherein said antibodyregion is a humanized antibody region.

P2 Embodiment 5. The method of P2 Embodiment 1, wherein said recombinantCAR protein further comprises an intracellular T-cell signaling domain.

P2 Embodiment 6. The method of P2 Embodiment 5, wherein saidintracellular T-cell signaling domain is a CD3 (intracellular T-cellsignaling domain.

P2 Embodiment 7. The method of P2 Embodiment 1, wherein said recombinantCAR protein further comprises an intracellular co-stimulatory signalingdomain.

P2 Embodiment 8. The method of P2 Embodiment 7, wherein saidintracellular co-stimulatory signaling domain is a CD28 intracellularco-stimulatory signaling domain, a 4-1BB intracellular co-stimulatorysignaling domain, a ICOS intracellular co-stimulatory signaling domain,or an OX-40 intracellular co-stimulatory signaling domain.

P2 Embodiment 9. The method of P2 Embodiment 1, wherein said recombinantCAR protein further comprises a spacer region.

P2 Embodiment 10. The method of P2 Embodiment 9, wherein said spacerregion is between said transmembrane domain and said antibody region.

P2 Embodiment 11. The method of P2 Embodiment 1, wherein saidrecombinant CAR protein further comprises a linker domain.

P2 Embodiment 12. The method of P2 Embodiment 11, wherein said linkerdomain is between said transmembrane domain and said intracellularT-cell signaling domain.

P2 Embodiment 13. The method of P2 Embodiment 11, wherein said linkerdomain is between said intracellular T-cell signaling domain and saidintracellular co-stimulatory signaling domain.

P2 Embodiment 14. The method of P2 Embodiment 11, wherein said linkerdomain comprises the sequence GGCGG or GGG.

P2 Embodiment 15. The method of P2 Embodiment 1, wherein saidrecombinant CAR protein is an anti-CD19 protein, anti-CD20 protein,anti-CD22 protein, anti-CD30 protein, anti-CD33 protein, anti-CD44v6/7/8protein, anti-CD123 protein, anti-CEA protein, anti-EGP-2 protein,anti-EGP-40 protein, anti-erb-B2 protein, anti-erb-B2,3,4 protein,anti-FBP protein, anti-fetal acetylcholine receptor protein, anti-GD2protein, anti-GD3 protein, anti-Her2/neu protein, anti-IL-13R-a2protein, anti-KDR protein, anti k-light chain protein, anti-LeY protein,anti-L1 cell adhesion molecule protein, anti-MAGE-A1 protein,anti-mesothelin protein, anti-murine CMV infected cell protein,anti-MUC2 protein, anti-NKGD2 protein, anti, oncofetal antigen protein,anti-PCSA protein, anti-PSMA protein, anti-TAA (targeted by mAb IfE)protein, anti-EGFR protein, anti-TAG-72 protein or anti-VEGF-72 protein.

P2 Embodiment 16. The method of any one of P2 Embodiments 1-15, whereinthe step of administering a viral vector to the patient comprisesadministering recombinant MVA virus.

P2 Embodiment 17. The method of any one of P2 Embodiments 1-16, whereinexpression of (i) CMV pp65 and (ii) the fusion protein comprising exon 4of CMV protein IE1 (e4) and exon 5 of CMV protein IE2 (e5) is under thecontrol of mH5 promoter.

P2 Embodiment 18. The method of P2 Embodiment 1, wherein the step ofproviding a population of T cells expressing a T cell receptor specificfor a CMV antigen and a recombinant CAR protein comprises: (a) providingPBMC or a T cell subpopulation from a CMV-seropositive human donor; (b)exposing the PBMC or the T cell subpopulation to at least one CMVantigen; (c) treating the exposed cells to produce a population of cellsenriched for stimulated cells specific for CMV; (d) transducing at leasta portion of the enriched population of cells with a vector expressing arecombinant CAR protein.

P2 Embodiment 19. The method of P2 Embodiment 18, wherein the step oftreating the exposed cells to produce a population of cells enriched forstimulated cells specific for CMV comprises treating the stimulatedcells to produce a population of cells enriched for cells expressing anactivation marker.

P2 Embodiment 20. The method of P2 Embodiment 1, wherein the step ofproviding a population of T cell expressing a T cell receptor specificfor a CMV antigen and a recombinant CAR protein comprises: (a)administering a viral vector encoding: (i) CMV pp65 and (ii) a fusionprotein comprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMVprotein IE2 (e5) to a human donor to convert a CMV-seronegative humandonor to one containing T cells responsive to CMV antigens pp65, IE1 andIE2; (b) obtaining PBMC from the CMV-seropositive human donor; (c)exposing the PBMC to at least one CMV antigen; (d) treating the exposedcells to produce a population of cells enriched for stimulated cellsspecific for CMV; and (e) transducing at least a portion of the enrichedpopulation of cells with a vector expressing a recombinant CAR protein,thereby providing a population of T cell expressing a recombinant CARprotein and a T cell receptor specific for a CMV antigen.

P2 Embodiment 21. The method of P2 Embodiment 1, wherein the step ofproviding a population of T cell expressing a T cell receptor specificfor a CMV antigen and a recombinant CAR protein comprises: (a)administering a viral vector encoding: (i) CMV pp65 and (ii) a fusionprotein comprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMVprotein IE2 (e5) to a CMV-seropositive human donor; (b) obtaining PBMCfrom the CMV-seropositive human donor; (b) exposing the PBMC to at leastone CMV antigen; (c) treating the exposed cells to produce a populationof cells enriched for stimulated cells specific for CMV; (d) transducingat least a portion of the enriched population of cells with a vectorexpressing a recombinant CAR protein, thereby providing a population ofT cell expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen.

P2 Embodiment 22. A method for preparing T cells expressing arecombinant CAR protein and a T cell receptor specific for a CMVantigen, the method comprising: (a) administering a viral vectorencoding: (i) CMV pp65 and (ii) a fusion protein comprising exon 4 ofCMV protein IE1 (e4) and exon 5 of CMV protein IE2 (e5) to a human donorto convert a CMV-seronegative human donor to one containing T cellsresponsive to CMV antigens pp65, IE1 and IE2; (b) obtaining PBMC fromthe CMV-seropositive human donor; (b) exposing the PBMC to at least oneCMV antigen; (c) treating the exposed cells to produce a population ofcells enriched for stimulated cells specific for CMV; (d) transducing atleast a portion of the enriched population of cells with a vectorexpressing a recombinant CAR protein, thereby providing a population ofT cell expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen.

P2 Embodiment 23. A method for preparing T cells expressing arecombinant CAR protein and a T cell receptor specific for a CMVantigen, the method comprising: a) administering a viral vectorencoding: (i) CMV pp65 and (ii) a fusion protein comprising exon 4 ofCMV protein IE1 (e4) and exon 5 of CMV protein IE2 (e5) to aCMV-seropositive human donor; (b) obtaining PBMC from theCMV-seropositive human donor; (b) exposing the PBMC to at least one CMVantigen; (c) treating the exposed cells to produce a population of cellsenriched for stimulated cells specific for CMV; (d) transducing at leasta portion of the enriched population of cells with a vector expressing arecombinant CAR protein, thereby providing a population of T cellexpressing a recombinant CAR protein and a T cell receptor specific fora CMV antigen.

P2 Embodiment 24. A method for treating a patient comprising:

(a) providing a composition comprising a population of T cellsexpressing both a T cell receptor specific for a viral antigen and arecombinant CAR protein,

wherein said recombinant CAR protein comprises:

(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain;(b) administering the composition to the patient; and(c) administering to the patient said viral antigen either prior to orsubsequent to administering the composition comprising a population of Tcells to the patient.

P2 Embodiment 25. The method of P2 Embodiment 24, wherein said viralantigen is an endogenous viral antigen.

P2 Embodiment 26. A cell comprising a T cell receptor specific for acytomegalovirus (CMV) antigen and a recombinant CAR protein,

wherein said recombinant CAR protein comprises:

(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain.

P2 Embodiment 27. A cell comprising a T cell receptor specific for aviral antigen and a recombinant CAR protein,

wherein said recombinant CAR protein comprises:

(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain.

Further Embodiments

Embodiment 1. A method for treating a disease in a subject in needthereof, said method comprising:

(i) administering to a subject a therapeutically effective amount of acomposition comprising a population of human T cells expressing a T cellreceptor specific for a cytomegalovirus (CMV) antigen and a recombinantchimeric antigen receptor (CAR) protein, wherein said recombinant CARprotein comprises:(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain; and(ii) administering to said subject a therapeutically effective amount ofa viral vector, wherein said viral vector encodes (a) a CMV pp65 proteinand (b) a fusion protein comprising exon 4 of CMV protein IE11 (e4) andexon 5 of CMV protein IE2 (e5); andwherein said viral vector is administered either prior to or subsequentto administering said composition comprising a population of human Tcells to said subject, thereby treating said subject.

Embodiment 2. The method of Embodiment 1, wherein said antibody regionis an antibody fragment.

Embodiment 3. The method of Embodiment 1, wherein said antibody regioncomprises an Fc domain.

Embodiment 4. The method of Embodiment 1, wherein said antibody regionis a humanized antibody region.

Embodiment 5. The method of Embodiment 1, wherein said recombinant CARprotein further comprises an intracellular T-cell signaling domain.

Embodiment 6. The method of Embodiment 5, wherein said intracellularT-cell signaling domain is a CD3 (intracellular T-cell signaling domain.

Embodiment 7. The method of Embodiment 1, wherein said recombinant CARprotein further comprises an intracellular co-stimulatory signalingdomain.

Embodiment 8. The method of Embodiment 7, wherein said intracellularco-stimulatory signaling domain is a CD28 intracellular co-stimulatorysignaling domain, a 4-1BB intracellular co-stimulatory signaling domain,a ICOS intracellular co-stimulatory signaling domain, or an OX-40intracellular co-stimulatory signaling domain.

Embodiment 9. The method of Embodiment 1, wherein said recombinant CARprotein further comprises a spacer region.

Embodiment 10. The method of Embodiment 9, wherein said spacer region isbetween said transmembrane domain and said antibody region.

Embodiment 11. The method of Embodiment 1, wherein said recombinant CARprotein further comprises a linker domain.

Embodiment 12. The method of Embodiment 11, wherein said linker domainis between said transmembrane domain and said intracellular T-cellsignaling domain.

Embodiment 13. The method of Embodiment 11, wherein said linker domainis between said intracellular T-cell signaling domain and saidintracellular co-stimulatory signaling domain.

Embodiment 14. The method of Embodiment 11, wherein said linker domaincomprises the sequence GGCGG or GGG.

Embodiment 15. The method of Embodiment 1, wherein said recombinant CARprotein is an anti-CD19 protein, anti-CD20 protein, anti-CD22 protein,anti-CD30 protein, anti-CD33 protein, anti-CD44v6/7/8 protein,anti-CD123 protein, anti-CEA protein, anti-EGP-2 protein, anti-EGP-40protein, anti-erb-B2 protein, anti-erb-B2,3,4 protein, anti-FBP protein,anti-fetal acetylcholine receptor protein, anti-GD2 protein, anti-GD3protein, anti-Her2/neu protein, anti-IL-13R-a2 protein, anti-KDRprotein, anti k-light chain protein, anti-LeY protein, anti-L1 celladhesion molecule protein, anti-MAGE-A1 protein, anti-mesothelinprotein, anti-murine CMV infected cell protein, anti-MUC2 protein,anti-NKGD2 protein, anti, oncofetal antigen protein, anti-PCSA protein,anti-PSMA protein, anti-TAA (targeted by mAb IfE) protein, anti-EGFRprotein, anti-TAG-72 protein or anti-VEGF-72 protein.

Embodiment 16. The method of any one of Embodiments 1-15, wherein saidstep of administering a therapeutically effective amount of a viralvector to said subject comprises administering recombinant MVA virus.

Embodiment 17. The method of any one of Embodiments 1-16, whereinexpression of (a) a CMV pp65 protein and (b) said fusion proteincomprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) is under the control of mH5 promoter.

Embodiment 18. The method of any one of Embodiments 1-17, wherein saidsubject is immunocompromised.

Embodiment 19. The method of any one of Embodiments 1-18, wherein saidsubject receives immunosuppressive therapy.

Embodiment 20. The method of any one of Embodiments 1-17, wherein saidsubject is immunocompetent.

Embodiment 21. The method of any one of Embodiments 1-20, wherein saidsubject is CMV-seronegative prior to treatment.

Embodiment 22. The method of any one of Embodiments 1-21, wherein saidsubject received hematopoietic stem cells (HSCs) from a CMV-seropositiveor a CMV-seronegative donor prior to administering said atherapeutically effective amount of said composition comprising apopulation of human T cells expressing a T cell receptor specific for aCMV antigen and a recombinant CAR protein.

Embodiment 23. The method of Embodiment 22, wherein said viral vector isadministered to said hematopoietic stem cell donor prior to harvestingsaid stem cells.

Embodiment 24. The method of any one of Embodiments 1-23, wherein saidrecombinant CAR protein is capable of binding CD19.

Embodiment 25. The method of any one of Embodiments 1-23, wherein saidrecombinant CAR protein is capable of binding HER2.

Embodiment 26. The method of any one of Embodiments 22-25, wherein saidHSCs are autologous HSCs.

Embodiment 27. The method of any one of Embodiments 22-25, wherein saidHSCs are allogenic HSCs.

Embodiment 28. The method of any one of Embodiments 1-27, wherein saidsubject is suffering from cancer.

Embodiment 29. The method of any one of Embodiments 1-28, wherein saidsubject is suffering from non-Hodgkin's Lymphoma.

Embodiment 30. The method of any one of Embodiments 1-28, wherein saidsubject is suffering from a solid tumor cancer or a hematologicmalignancy

Embodiment 31. The method of any one of Embodiments 1-28, wherein saidsubject is suffering from ovarian cancer, renal cell carcinoma, a B-cellmalignancy, leukemia, lymphoma, breast cancer, colorectal cancer,prostate cancer, neuroblastoma, melanoma, medulloblastoma, lung cancer,osteosarcoma, glioblastoma or glioma.

Embodiment 32. The method of any one of Embodiments 1-31, whereinadministration of said viral vector occurs at least 5 days aftertreatment with said composition comprising a population of human Tcells.

Embodiment 33. The method of any one of Embodiments 1-31, wherein saidviral vector is administered to said subject prior to and subsequent tosaid administration of said composition comprising a population of humanT cells.

Embodiment 34. The method of any one of Embodiments 1-31, wherein saidviral vector is administered to said subject only prior to saidadministration of said composition comprising a population of human Tcells.

Embodiment 35. The method of any one of Embodiments 1-31, wherein saidviral vector is administered to said subject only subsequent to saidadministration of said composition comprising a population of human Tcells.

Embodiment 36. The method of any one of Embodiments 1-35, wherein saidviral vector is administered to said subject or said hematopoietic stemcell transplant donor at least twice subsequent to said administrationof said composition comprising a population of human T cells.

Embodiment 37. The method of any one of Embodiments 1-36, wherein saidviral vector is administered to said subject at least four times.

Embodiment 38. The method of Embodiment 1, wherein said population ofhuman T cells expressing a T cell receptor specific for a CMV antigenand a recombinant CAR protein is formed by: (1) isolating PBMCs or a Tcell subpopulation from a CMV-seropositive human donor; (2) contactingsaid PBMCs or said T cell subpopulation with at least one CMV antigen;(3) allowing said contacted cells to produce a population of cellsenriched for stimulated cells specific for CMV; (4) transducing at leasta portion of said enriched population of cells with a vector expressinga recombinant CAR protein, thereby forming a population of human T cellsexpressing a T cell receptor specific for a CMV antigen and arecombinant CAR protein.

Embodiment 39. The method of Embodiment 38, wherein said step ofallowing said contacted cells to produce a population of cells enrichedfor stimulated cells specific for CMV comprises allowing said stimulatedcells to produce a population of cells enriched for cells expressing anactivation marker.

Embodiment 40. The method of Embodiment 1, wherein said population ofhuman T cells expressing a T cell receptor specific for a CMV antigenand a recombinant CAR protein is formed by: (1) administering a viralvector encoding: (a) a CMV pp65 protein and (b) a fusion proteincomprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a human donor to convert a CMV-seronegative human donor to aCMV-seropositive human donor containing T cells responsive to CMVantigens pp65, IE1 and IE2; (2) obtaining PBMCs from saidCMV-seropositive human donor; (3) contacting said PBMCs with at leastone CMV antigen; (4) allowing said contacted cells to produce apopulation of cells enriched for stimulated cells specific for CMV; (5)transducing at least a portion of said enriched population of cells witha vector expressing a recombinant CAR protein, thereby forming apopulation of T cell expressing a T cell receptor specific for a CMVantigen and a recombinant CAR protein.

Embodiment 41. The method of Embodiment 1, wherein said population ofhuman T cells expressing a T cell receptor specific for a CMV antigenand a recombinant CAR protein is formed by: (1) administering a viralvector encoding: (a) a CMV pp65 protein and (b) a fusion proteincomprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a CMV-seropositive human donor; (2) allowing PBMCs from saidCMV-seropositive human donor; (3) contacting said PBMCs with at leastone CMV antigen; (4) allowing said contacted cells to produce apopulation of cells enriched for stimulated cells specific for CMV; (5)transducing at least a portion of said enriched population of cells witha vector expressing a recombinant CAR protein, thereby providing apopulation of human T cells expressing a T cell receptor specific for aCMV antigen and a recombinant CAR protein.

Embodiment 42. A method for forming a population of human T cellsexpressing a recombinant CAR protein and a T cell receptor specific fora CMV antigen, said method comprising: (1) administering a viral vectorencoding: (a) a CMV pp65 protein and (b) a fusion protein comprisingexon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2 (e5) to aCMV-seronegative human donor; (2) obtaining PBMCs from said human donor;(3) contacting said PBMCs with at least one CMV antigen; (3) allowingsaid contacted cells to produce a population of cells enriched forstimulated cells specific for CMV; (4) transducing at least a portion ofsaid enriched population of cells with a vector expressing a recombinantCAR protein, thereby forming a population of human T cells expressing aT cell receptor specific for a CMV antigen and a recombinant CARprotein.

Embodiment 43. A method for forming a population of human T cellsexpressing a recombinant CAR protein and a T cell receptor specific fora CMV antigen, said method comprising: (1) administering a viral vectorencoding: (a) a CMV pp65 protein and (b) a fusion protein comprisingexon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2 (e5) to aCMV-seropositive human donor; (2) obtaining PBMCs from saidCMV-seropositive human donor; (3) contacting said PBMCs with at leastone CMV antigen; (4) allowing said contacted cells to produce apopulation of cells enriched for stimulated cells specific for CMV; (5)transducing at least a portion of said enriched population of cells witha vector expressing a recombinant CAR protein, thereby forming apopulation of human T cells expressing a T cell receptor specific for aCMV antigen and a recombinant CAR protein.

Embodiment 44. The method of one of Embodiments 38-43, furthercomprising expanding said population of human T cells expressing arecombinant CAR protein and a T cell receptor specific for a CMVantigen.

Embodiment 45. The method of Embodiment 39, wherein said activationmarker is IFN-γ, CD137 or CD107.

Embodiment 46. The method of one of Embodiments 38-43, wherein said CMVantigen is a pp65 protein or an antigenic portion thereof.

Embodiment 47. The method of one of Embodiments 38-43, wherein said CMVantigen comprises two or more different antigenic pp65 proteins.

Embodiment 48. The method of one of Embodiments 38-43, wherein saidenriched population of cells is at least 40% IFN-γ positive, at least20% CD8 positive, and at least 20% CD4 positive.

Embodiment 49. The method of one of Embodiments 38-43, wherein saidenriched population of cells is cultured for fewer than 10 days prior tosaid step of transducing said enriched population of cells with a vectorencoding a recombinant CAR protein.

Embodiment 50. The method of one of Embodiments 38-43, furthercomprising expanding said CMV specific T cells expressing a recombinantCAR protein by exposing said T cells to an antigen that binds to saidrecombinant CAR protein.

Embodiment 51. The method of one of Embodiments 38-43, wherein said stepof expanding said CMV-specific T cells expressing a recombinant CARprotein comprises exposing said cells to T cells expressing said antigenthat binds said recombinant CAR protein.

Embodiment 52. The method of one of Embodiments 38-43, wherein saidexpansion takes place in the presence of at least one exogenously addedinterleukin.

Embodiment 53. The method of Embodiment 1, wherein said population ofhuman T cells is autologous to said subject.

Embodiment 54. The method of Embodiment 1, wherein said population ofhuman T cells is allogeneic to said subject.

Embodiment 55. The method of Embodiment 1, wherein said method reducesthe risk of CMV infection.

Embodiment 56. The method of Embodiment 1, wherein said method reducesCMV viremia and/or disease.

Embodiment 57. The method of Embodiment 1, wherein said subject wasCMV-immune prior to treatment and said method reduces the risk of CMVinfection.

Embodiment 58. The method of Embodiment 1, wherein said subject was notCMV-immune prior to treatment and said method reduces CMV viremia ordisease.

Embodiment 59. A method for treating a disease in a subject in needthereof comprising:

(i) administering to a subject a therapeutically effective amount of acomposition comprising a population of human T cells expressing a T cellreceptor specific for a viral antigen and a recombinant chimeric antigenreceptor (CAR) protein, wherein said recombinant CAR protein comprises:(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain; and(ii) administering to said subject said viral antigen either prior to orsubsequent to administering said composition comprising a population ofhuman T cells to said subject.

Embodiment 60. The method of Embodiment 59, wherein said viral antigenis an endogenous viral antigen.

Embodiment 61. A cell comprising a T cell receptor specific for acytomegalovirus (CMV) antigen and a recombinant CAR protein,

wherein said recombinant CAR protein comprises:

(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain.

Embodiment 62. A cell comprising a T cell receptor specific for a viralantigen and a recombinant CAR protein,

wherein said recombinant CAR protein comprises:

(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and(B) a transmembrane domain.

What is claimed is:
 1. A method for forming a population of human Tcells expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen, said method comprising: (1) administering aviral vector encoding: (a) a CMV pp65 protein and (b) a fusion proteincomprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a CMV-seronegative human donor; (2) obtaining PBMCs from saidhuman donor; (3) contacting said PBMCs with at least one CMV antigen;(3) allowing said contacted cells to produce a population of cellsenriched for stimulated cells specific for CMV; (4) transducing at leasta portion of said enriched population of cells with a vector expressinga recombinant CAR protein, thereby forming a population of human T cellsexpressing a T cell receptor specific for a CMV antigen and arecombinant CAR protein.
 2. A method for forming a population of human Tcells expressing a recombinant CAR protein and a T cell receptorspecific for a CMV antigen, said method comprising: (1) administering aviral vector encoding: (a) a CMV pp65 protein and (b) a fusion proteincomprising exon 4 of CMV protein IE1 (e4) and exon 5 of CMV protein IE2(e5) to a CMV-seropositive human donor; (2) obtaining PBMCs from saidCMV-seropositive human donor; (3) contacting said PBMCs with at leastone CMV antigen; (4) allowing said contacted cells to produce apopulation of cells enriched for stimulated cells specific for CMV; (5)transducing at least a portion of said enriched population of cells witha vector expressing a recombinant CAR protein, thereby forming apopulation of human T cells expressing a T cell receptor specific for aCMV antigen and a recombinant CAR protein.
 3. The method of claim 1,wherein said recombinant CAR protein comprises: (A) an antibody regioncomprising a central cavity formed by a heavy chain variable (VH)region, a light chain variable (VL) region, a heavy chain constantregion (CH) and a light chain constant region (CL), wherein said centralcavity forms a peptide binding site comprising framework region aminoacid residues; and (B) a transmembrane domain.
 4. The method of claim 3,further comprising after said transducing in (4) expanding saidpopulation of human T cells expressing a recombinant CAR protein and a Tcell receptor specific for a CMV antigen.
 5. The method of claim 4,wherein said expanding comprises exposing said human T cells expressinga recombinant CAR protein and a T cell receptor specific for a CMVantigen to an antigen that binds to said recombinant CAR protein.
 6. Themethod of claim 3, wherein said enriched population of cells is culturedfor fewer than 10 days prior to said step of transducing said enrichedpopulation of cells with a vector encoding a recombinant CAR protein. 7.The method of claim 2, wherein said recombinant CAR protein comprises:(A) an antibody region comprising a central cavity formed by a heavychain variable (VH) region, a light chain variable (VL) region, a heavychain constant region (CH) and a light chain constant region (CL),wherein said central cavity forms a peptide binding site comprisingframework region amino acid residues; and (B) a transmembrane domain. 8.The method of claim 7, further comprising after said transducing in (5)expanding said population of human T cells expressing a recombinant CARprotein and a T cell receptor specific for a CMV antigen.
 9. The methodof claim 8, wherein said expanding comprises exposing said human T cellsexpressing a recombinant CAR protein and a T cell receptor specific fora CMV antigen to an antigen that binds to said recombinant CAR protein.10. The method of claim 7, wherein said enriched population of cells iscultured for fewer than 10 days prior to said step of transducing saidenriched population of cells with a vector encoding a recombinant CARprotein.